Provider Demographics
NPI:1043633910
Name:OSWALD BAUER, NATIEL (PA)
Entity type:Individual
Prefix:
First Name:NATIEL
Middle Name:
Last Name:OSWALD BAUER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9990 DOUBLE R BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4833
Mailing Address - Country:US
Mailing Address - Phone:858-776-9124
Mailing Address - Fax:
Practice Address - Street 1:825 E ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6610
Practice Address - Country:US
Practice Address - Phone:405-364-7900
Practice Address - Fax:405-310-6866
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2018-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54645363A00000X
NV1861363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant