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General NPI Number Information
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NPI Number | 1528423043
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Entity Type | Individual
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Provider Name | NATALIA K PAK PA
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Gender | Female
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Dates
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Enumeration Date | 12/28/2015
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 4940 W UNIVERSITY DR STE 60
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City | PROSPER
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State | TX
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Zip | 75078-9914
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Country | US
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Telephone | 972-752-7111
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Fax | 512-782-9316
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Provider Business Mailing Address
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Address Line | 8300 N LAMAR BLVD STE 200A
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City | AUSTIN
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State | TX
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Zip | 78753-5976
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Country | US
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Telephone | 512-387-8208
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Fax | 512-782-9316
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA11730
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 019416
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License Number State | NY
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