Provider Demographics
NPI:1568550861
Name:CHRISTADOSS, NATHANIEL JASON (PT)
Entity Type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:JASON
Last Name:CHRISTADOSS
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:2212 SAM RAYBURN HWY
Mailing Address - Street 2:STE 200
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-2674
Mailing Address - Country:US
Mailing Address - Phone:972-837-4450
Mailing Address - Fax:972-837-4451
Practice Address - Street 1:2212 SAM RAYBURN HWY
Practice Address - Street 2:STE 200
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454-2674
Practice Address - Country:US
Practice Address - Phone:972-837-4450
Practice Address - Fax:972-837-4451
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2011-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX1169447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist