Provider Demographics
NPI:1497520191
Name:ANDERSON, NATIRA (RRT)
Entity Type:Individual
Prefix:
First Name:NATIRA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 MELISSA RIVER WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75212-2308
Mailing Address - Country:US
Mailing Address - Phone:214-682-9381
Mailing Address - Fax:
Practice Address - Street 1:3114 MELISSA RIVER WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-2308
Practice Address - Country:US
Practice Address - Phone:214-682-9381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRCP00075691227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered