MEDICARE: NATALIA BYGRAVE LP

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
1	103T00000X	Psychologist	40198	TX

General Provider Information

NPI Number	:	1609705656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA BYGRAVE LP

Provider Business Mailing Address
First Line	:	7272 WURZBACH RD STE 601
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4803
Country	:	US
Telephone Number	:	888-365-6271
Fax Number	:	210-593-9863

Provider Business Practice Location Address
First Line	:	7272 WURZBACH RD STE 601
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4803
Country	:	US
Telephone Number	:	888-365-6271
Fax Number	:	210-593-9863

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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