Provider Demographics
NPI:1255611273
Name:CAMACHO, NATASHA ANNA (PTA)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:ANNA
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 SPRINGTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-3226
Mailing Address - Country:US
Mailing Address - Phone:210-912-8827
Mailing Address - Fax:
Practice Address - Street 1:176 SPRINGTREE PKWY
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-3226
Practice Address - Country:US
Practice Address - Phone:210-912-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant