Provider Information for 1831863638
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NATHALIE VIOLETTE BUITRAGO
Sex: Female
NPI: 1831863638
Last Updated: 2022-11-09
Certification Date: 2022-11-09
Certification Date: 2022-11-09
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1831863638 | ||||||||||||||||
| Enumeration Date | 2021-08-04 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1977 BUTLER BLVD HOUSTON, TX 77030-4101 United States Phone: 718-873-5270 | Fax: | ||||||||||||||||
| Primary Practice Address | 1504 TAUB LOOP HOUSTON, TX 77030-1608 United States Phone: 713-873-8890 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 2300 RICHMOND AVE APT 541 | ||||||||||||||||
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