Provider Demographics
NPI:1316924343
Name:DRYDEN, NATALIE J (MD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:J
Last Name:DRYDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6560 FANNIN ST STE 1130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2790
Mailing Address - Country:US
Mailing Address - Phone:713-363-8055
Mailing Address - Fax:713-790-1060
Practice Address - Street 1:6560 FANNIN ST STE 1130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2790
Practice Address - Country:US
Practice Address - Phone:713-363-8055
Practice Address - Fax:713-790-1060
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2016-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6363207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158635602Medicaid
TX4282660OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX8FT517OtherBLUE CROSS BLUE SHIELD
TX8EQ585OtherBLUE CROSS BLUE SHIELD
TX158635601Medicaid
TX4282660OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX8EQ585OtherBLUE CROSS BLUE SHIELD
TXP00023329Medicare PIN
TX158635602Medicaid
TX371876ZSWDMedicare PIN