Basic Information
Provider Information | |||||||||
NPI: | 1477559268 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | NATAL | ||||||||
FirstName: | NORMA | ||||||||
MiddleName: | IRIS | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | CASTRO | ||||||||
OtherFirstName: | NORMA | ||||||||
OtherMiddleName: | IRIS | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 11509 NW 6TH ST | ||||||||
Address2: |   | ||||||||
City: | YUKON | ||||||||
State: | OK | ||||||||
PostalCode: | 730996568 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4053242447 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | RR 1 BOX 3060 | ||||||||
Address2: |   | ||||||||
City: | CLINTON | ||||||||
State: | OK | ||||||||
PostalCode: | 736019303 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5803232884 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/26/2005 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | X | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 15454 | PR | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   |
No ID Information.