Provider Demographics
NPI:1386256220
Name:SADIQ, NATORIA SHANTELL
Entity type:Individual
Prefix:
First Name:NATORIA
Middle Name:SHANTELL
Last Name:SADIQ
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 1:6031 OAKMERE LN
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-1920
Mailing Address - Country:US
Mailing Address - Phone:469-406-8796
Mailing Address - Fax:
Practice Address - Street 1:6031 OAKMERE LN
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-1920
Practice Address - Country:US
Practice Address - Phone:469-406-8796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRCP00076552227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Single Specialty