Provider Demographics
NPI:1528423043
Name:PAK, NATALIA K (PA)
Entity type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:K
Last Name:PAK
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:8300 N LAMAR BLVD STE 200A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5976
Mailing Address - Country:US
Mailing Address - Phone:512-387-8208
Mailing Address - Fax:512-782-9316
Practice Address - Street 1:4940 W UNIVERSITY DR STE 60
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9914
Practice Address - Country:US
Practice Address - Phone:972-752-7111
Practice Address - Fax:512-782-9316
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2023-04-21
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Provider Licenses
StateLicense IDTaxonomies
TXPA11730363A00000X
NY019416363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant