Healthcare Provider Details

I. General information

NPI: 1467444372
Provider Name (Legal Business Name): NATALIE PEVETO D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3674 HIGHWAY 96 BYP
SILSBEE TX
77656-7622
US

IV. Provider business mailing address

PO BOX 1838
SILSBEE TX
77656-1838
US

V. Phone/Fax

Practice location:
  • Phone: 409-385-6369
  • Fax: 409-385-6369
Mailing address:
  • Phone: 409-385-6369
  • Fax: 409-385-6369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8529
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: