Provider Demographics
NPI:1467444372
Name:PEVETO, NATALIE (DC)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:PEVETO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1838
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-1838
Mailing Address - Country:US
Mailing Address - Phone:409-385-6369
Mailing Address - Fax:409-385-6369
Practice Address - Street 1:3674 HIGHWAY 96 BYP
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-7622
Practice Address - Country:US
Practice Address - Phone:409-385-6369
Practice Address - Fax:409-385-6369
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609366OtherBLUE CROSS BLUE SHEILD
TX7640153OtherAETNA PROVIDER NUMBER
TX1844567OtherFIRST HEALTH
TX1845159-003OtherCIGNA
TXU79834Medicare UPIN
609421Medicare ID - Type Unspecified