Provider Demographics
NPI:1285660712
Name:ENABNIT, NATALIE CRYSTAL (PA)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:CRYSTAL
Last Name:ENABNIT
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12402 SLIDE RD STE 402
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-8322
Mailing Address - Country:US
Mailing Address - Phone:806-544-9248
Mailing Address - Fax:806-642-0042
Practice Address - Street 1:6205 43RD ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-3828
Practice Address - Country:US
Practice Address - Phone:806-749-2263
Practice Address - Fax:806-749-2264
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA04264363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q30339Medicare UPIN