Provider Demographics
NPI:1467626952
Name:MAZAHERI, NATASHA (DC)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:MAZAHERI
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 1:607 FERRIS AVE
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-3029
Mailing Address - Country:US
Mailing Address - Phone:972-923-1003
Mailing Address - Fax:972-923-1009
Practice Address - Street 1:112 S MCKINNEY ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-4755
Practice Address - Country:US
Practice Address - Phone:972-875-8600
Practice Address - Fax:972-875-8481
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor