Provider Demographics
NPI:1366025447
Name:BUBECK, NATASHA MARIA (MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:MARIA
Last Name:BUBECK
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 CAT MOUNTAIN TRL
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3217
Mailing Address - Country:US
Mailing Address - Phone:850-313-0704
Mailing Address - Fax:
Practice Address - Street 1:1001 W ARBROOK BLVD STE 161
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4222
Practice Address - Country:US
Practice Address - Phone:817-402-0952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX830601163WW0000X
TX1037049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000OtherN/A