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NPI Code Detail

MEDICARE: NATALIE ETHERSON

MEDICARE: NATALIE ETHERSON
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
1225XP0200XPediatric Occupational Therapist126204TX

General Provider Information

NPI Number : 1639024821
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE ETHERSON
Provider Business Mailing Address
First Line : 28814 ENCHANTED DR
Second Line :
City : SHENANDOAH
State : TX
Zip : 77381-1103
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6621 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2358
Country : US
Telephone Number : 832-824-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “ NATALIE ETHERSON ” Practice Location

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