Provider Demographics
NPI:1982270385
Name:FREEMAN, NATHANAEL CHARLES
Entity Type:Individual
Prefix:
First Name:NATHANAEL
Middle Name:CHARLES
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 EAGLE POINT RD
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532-3246
Mailing Address - Country:US
Mailing Address - Phone:832-774-8540
Mailing Address - Fax:
Practice Address - Street 1:2107 EAGLE POINT RD
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-3246
Practice Address - Country:US
Practice Address - Phone:832-774-8540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider