MEDICARE: NATASHA JOSEPHINE CARL PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	1350004	TX

General Provider Information

NPI Number	:	1508582917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA JOSEPHINE CARL PT, DPT

Provider Business Mailing Address
First Line	:	3202 HARPERS FERRY LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-6723
Country	:	US
Telephone Number	:	925-989-2844
Fax Number	:

Provider Business Practice Location Address
First Line	:	2712 BEE CAVES RD STE 122A
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-5662
Country	:	US
Telephone Number	:	512-335-9300
Fax Number	:	512-335-9301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	10/17/2022

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