Provider Demographics
NPI:1467933390
Name:OAKSFORD, NATHAN MICHEL (PTA)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:MICHEL
Last Name:OAKSFORD
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 SONG BIRD CIR
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-6488
Mailing Address - Country:US
Mailing Address - Phone:325-646-4750
Mailing Address - Fax:325-643-5250
Practice Address - Street 1:2205 14TH ST
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-8019
Practice Address - Country:US
Practice Address - Phone:585-356-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292870164W00000X
NY008635225200000X
TX2094326225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No164W00000XNursing Service ProvidersLicensed Practical Nurse