Provider Demographics
NPI:1467191304
Name:MACDOUGALL, NATALIE (DPT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:MACDOUGALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:KOSCHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1300 KELLER PKWY APT 2311
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-1616
Mailing Address - Country:US
Mailing Address - Phone:817-899-6637
Mailing Address - Fax:
Practice Address - Street 1:1652 KELLER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3876
Practice Address - Country:US
Practice Address - Phone:817-562-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3128616225100000X, 2251P0200X
TX1364668225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics