Provider Demographics
NPI:1275381410
Name:HERNANDEZ VAZQUEZ, NATASHA ALONDRA (PT, DPT)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:ALONDRA
Last Name:HERNANDEZ VAZQUEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4624 LIZZY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-6450
Mailing Address - Country:US
Mailing Address - Phone:972-904-0152
Mailing Address - Fax:
Practice Address - Street 1:4624 LIZZY DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-6450
Practice Address - Country:US
Practice Address - Phone:972-904-0152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1391652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist