Provider Demographics
NPI:1508860198
Name:TOLBERT-BORNSTEIN, NATALIE (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:TOLBERT-BORNSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 TRAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3040
Mailing Address - Country:US
Mailing Address - Phone:915-591-4632
Mailing Address - Fax:915-591-4069
Practice Address - Street 1:2260 TRAWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3040
Practice Address - Country:US
Practice Address - Phone:915-591-4632
Practice Address - Fax:915-591-4069
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1563207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB152437OtherWELLMED PTAN
TX1152407-03Medicaid
TX115240704Medicaid
TX87T505OtherMEDICARE
TX1152407-03Medicaid