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General NPI Number Information
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NPI Number | 1497526321
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Entity Type | Individual
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Provider Name | NATASHA PYLANT PTA, BS
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Gender | Female
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 609 MEDICAL CENTER DR
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City | DECATUR
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State | TX
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Zip | 76234-3836
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Country | US
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Telephone | 940-626-1360
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Fax |
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Provider Business Mailing Address
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Address Line | 2107 RIDGEWOOD DR
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City | BRIDGEPORT
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State | TX
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Zip | 76426-3343
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Country | US
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Telephone | 580-272-7480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2104973
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License Number State | TX
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