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NPI Code Detail

MEDICARE: NATASHA TSANDOULA

MEDICARE: NATASHA TSANDOULA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-15-02147TX

General Provider Information

NPI Number : 1538667894
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA TSANDOULA
Provider Business Mailing Address
First Line : 234 W BANDERA RD
Second Line :
City : BOERNE
State : TX
Zip : 78006-2805
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2525 LADD ST
Second Line :
City : LACKLAND AFB
State : TX
Zip : 78236-5308
Country : US
Telephone Number : 225-505-8024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2018
Last Update Date : 01/31/2018

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Directions to “ NATASHA TSANDOULA ” Practice Location

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