Provider Demographics
NPI:1255613774
Name:BESTER, NATOLIE ANN (LMT)
Entity type:Individual
Prefix:
First Name:NATOLIE
Middle Name:ANN
Last Name:BESTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 KRENEK TAP RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-5026
Mailing Address - Country:US
Mailing Address - Phone:979-347-2791
Mailing Address - Fax:
Practice Address - Street 1:943 WILLIAM D FITCH PKWY STE 601
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6367
Practice Address - Country:US
Practice Address - Phone:979-574-5241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT113318225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist