Provider Demographics
NPI:1447570999
Name:KAZAKEVICH, NATALIA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:
Last Name:KAZAKEVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9074 ROCKY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-5615
Mailing Address - Country:US
Mailing Address - Phone:281-466-1891
Mailing Address - Fax:281-296-9044
Practice Address - Street 1:5314 DASHWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4603
Practice Address - Country:US
Practice Address - Phone:713-600-9500
Practice Address - Fax:281-296-9044
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP07422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP0742OtherMEDICAL LICENSE
TX425472ZP9QMedicare PIN