Provider Demographics
NPI:1912502949
Name:VALA, NATALIE CHRISTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:CHRISTINE
Last Name:VALA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 BENNETT AVE APT 3316
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-7573
Mailing Address - Country:US
Mailing Address - Phone:561-414-8123
Mailing Address - Fax:
Practice Address - Street 1:5917 BELT LINE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7703
Practice Address - Country:US
Practice Address - Phone:972-726-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant