Healthcare Provider Details

I. General information

NPI: 1013602952
Provider Name (Legal Business Name): NATALIE ROSE WESTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 RED RIVER, 2ND FLOOR, GME OFFICE DELL MEDICAL SCHOOL AT THE UNIVERSITY OF TEXAS
AUSTIN TX
78712
US

IV. Provider business mailing address

1501 RED RIVER, 2ND FLOOR, GME OFFICE DELL MEDICAL SCHOOL AT THE UNIVERSITY OF TEXAS
AUSTIN TX
78712
US

V. Phone/Fax

Practice location:
  • Phone: 512-495-5555
  • Fax:
Mailing address:
  • Phone: 512-495-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number764897
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: