Provider Demographics
NPI:1285080879
Name:HIDDEMEN, NATALIE (PT, DPT, NCS)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:HIDDEMEN
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 PARKCREST DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4975
Mailing Address - Country:US
Mailing Address - Phone:512-345-4664
Mailing Address - Fax:512-345-6150
Practice Address - Street 1:5608 PARKCREST DR
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4975
Practice Address - Country:US
Practice Address - Phone:512-345-4664
Practice Address - Fax:512-345-6150
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1198439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist