Provider Demographics
NPI:1225768989
Name:COLLAZO, NATALIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:COLLAZO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18100 WEST RD APT 1409
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-3788
Mailing Address - Country:US
Mailing Address - Phone:409-293-6136
Mailing Address - Fax:
Practice Address - Street 1:13611 SKINNER RD STE 240
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4691
Practice Address - Country:US
Practice Address - Phone:281-256-8212
Practice Address - Fax:281-783-2303
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81141231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist