Individual
EDIK NATANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5432 HUFFINES BLVD APT 5204, FORT WORTH, TX 76179-5634
(347) 975-5146
Mailing address
5432 HUFFINES BLVD APT 5204, FORT WORTH, TX 76179-5634
(347) 975-5146
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
51638335
TX
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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