Basic Information
Provider Information
NPI: 1003004201
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PHILBRICK
FirstName: NATALIE
MiddleName: W
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3301 S ALAMEDA ST STE 201
Address2:  
City: CORPUS CHRISTI
State: TX
PostalCode: 784111870
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3301 S ALAMEDA ST STE 201
Address2:  
City: CORPUS CHRISTI
State: TX
PostalCode: 784111870
CountryCode: US
TelephoneNumber: 3618572900
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/12/2007
LastUpdateDate: 10/28/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X2112MEY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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