MEDICARE: NATALIA WATTS P.A.

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	363AM0700X	Medical Physician Assistant	PA07663	TX
2	363A00000X	Physician Assistant	PA07663	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1750643821	OTHER	TX	NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750643821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA WATTS P.A.

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1230
Country	:	US
Telephone Number	:	972-997-8000
Fax Number	:	972-234-2987

Provider Business Practice Location Address
First Line	:	5920 W PARKER RD STE 100
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-6413
Country	:	US
Telephone Number	:	214-491-5858
Fax Number	:	972-731-5688

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

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	10/26/2022

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Directions to “ NATALIA WATTS P.A.” Practice Location

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