Provider Demographics
NPI:1710390067
Name:MINAMI, NATHALIE YUKI (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHALIE
Middle Name:YUKI
Last Name:MINAMI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2260 TRAWOOD DR STE C
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3042
Mailing Address - Country:US
Mailing Address - Phone:915-591-4632
Mailing Address - Fax:915-591-4069
Practice Address - Street 1:2260 TRAWOOD DR STE C
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3042
Practice Address - Country:US
Practice Address - Phone:915-591-4632
Practice Address - Fax:915-591-4069
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS1455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1710390067Medicaid