Provider Demographics
NPI:1073354783
Name:PEREZ RODRIGUEZ, NATALIE M
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:PEREZ RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DRIVE
Mailing Address - Street 2:MCMR - SRT - T
Mailing Address - City:JBSA FT. SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-5658
Mailing Address - Fax:210-271-0830
Practice Address - Street 1:3551 ROGER BROOKE DRIVE
Practice Address - Street 2:MCMR - SRT - T
Practice Address - City:JBSA FT. SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-5658
Practice Address - Fax:210-271-0830
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program