MEDICARE: NATALIE BASSETT

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	225100000X	Physical Therapist	1379165	TX

General Provider Information

NPI Number	:	1649952904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE BASSETT

Provider Business Mailing Address
First Line	:	1130 BEACHVIEW ST STE 110
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3704
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 BEACHVIEW ST STE 110
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-3704
Country	:	US
Telephone Number	:	214-538-2559
Fax Number	:

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

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	08/04/2023

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Directions to “ NATALIE BASSETT ” Practice Location

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