Provider Demographics
NPI:1801377023
Name:MOTONGO, NATASHA DAMARA (AGCNS-BC)
Entity type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:DAMARA
Last Name:MOTONGO
Suffix:
Gender:F
Credentials:AGCNS-BC
Other - Prefix:MRS
Other - First Name:NATASHA
Other - Middle Name:DAMARA
Other - Last Name:WEGESA MOTONGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12319 N MOPAC EXPY STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2497
Mailing Address - Country:US
Mailing Address - Phone:512-694-8888
Mailing Address - Fax:512-973-9552
Practice Address - Street 1:12319 N MOPAC EXPY STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2497
Practice Address - Country:US
Practice Address - Phone:512-694-8888
Practice Address - Fax:512-973-9552
Is Sole Proprietor?:No
Enumeration Date:2018-08-25
Last Update Date:2025-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138594364SA2200X, 364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology