Provider Demographics
NPI:1093332538
Name:GORDON, NATALIE DANIELLE (MD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:DANIELLE
Last Name:GORDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W PECAN ST STE 450
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3154
Mailing Address - Country:US
Mailing Address - Phone:512-978-9840
Mailing Address - Fax:512-901-9768
Practice Address - Street 1:2700 W PECAN ST STE 450
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3154
Practice Address - Country:US
Practice Address - Phone:512-978-9840
Practice Address - Fax:512-901-9768
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6492207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine