Provider Demographics
NPI:1609248293
Name:OVERSTREET, NATALIE (MS, RDN, LD, CNSC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:MS, RDN, LD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 COUNTY ROAD 3527
Mailing Address - Street 2:
Mailing Address - City:BULLARD
Mailing Address - State:TX
Mailing Address - Zip Code:75757-7704
Mailing Address - Country:US
Mailing Address - Phone:903-216-3799
Mailing Address - Fax:
Practice Address - Street 1:283 COUNTY ROAD 3527
Practice Address - Street 2:
Practice Address - City:BULLARD
Practice Address - State:TX
Practice Address - Zip Code:75757-7704
Practice Address - Country:US
Practice Address - Phone:903-216-3799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82180133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered