Provider Demographics
NPI:1033302815
Name:DEBRA F. LATIMER NUTRITION AND DIABETES ASSOCIATES
Entity Type:Organization
Organization Name:DEBRA F. LATIMER NUTRITION AND DIABETES ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:F
Authorized Official - Last Name:LATIMER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD, CDE
Authorized Official - Phone:713-795-0876
Mailing Address - Street 1:6300 WEST LOOP SOUTH
Mailing Address - Street 2:SUITE 333
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2421
Mailing Address - Country:US
Mailing Address - Phone:713-795-0876
Mailing Address - Fax:713-432-7989
Practice Address - Street 1:6300 WEST LOOP SOUTH
Practice Address - Street 2:SUITE 333
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-795-0876
Practice Address - Fax:713-432-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT01014133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty