Healthcare Provider Details

I. General information

NPI: 1063836583
Provider Name (Legal Business Name): NATALIE BUMPAS ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10600 PRESTON RD
DALLAS TX
75230-4000
US

IV. Provider business mailing address

10600 PRESTON RD
DALLAS TX
75230-4000
US

V. Phone/Fax

Practice location:
  • Phone: 214-346-8436
  • Fax:
Mailing address:
  • Phone: 214-346-8436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberAT8244
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: