Basic Information
| Provider Information | |||||||||
| NPI: | 1467933390 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OAKSFORD | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | MICHEL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2500 SONG BIRD CIR | ||||||||
| Address2: | |||||||||
| City: | BROWNWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 768016488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256464750 | ||||||||
| FaxNumber: | 3256435250 | ||||||||
| Practice Location | |||||||||
| Address1: | 2205 14TH ST | ||||||||
| Address2: | |||||||||
| City: | BROWNWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 768018019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853567132 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2018 | ||||||||
| LastUpdateDate: | 08/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 292870 | NY | N | Nursing Service Providers | Licensed Practical Nurse | 225200000X | 008635 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | 225200000X | 2094326 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.