Provider Demographics
NPI:1295218535
Name:RIOS, NATALIE MARIE (PSYD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:RIOS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22835 TORNILLO DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2591
Mailing Address - Country:US
Mailing Address - Phone:787-356-7303
Mailing Address - Fax:
Practice Address - Street 1:9500 RAY WHITE RD STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-9105
Practice Address - Country:US
Practice Address - Phone:682-600-3171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39583103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical