Provider Demographics
NPI:1063833374
Name:SIMPSON, DEBORAH (RD, LD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 IRIONA BND
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4913
Mailing Address - Country:US
Mailing Address - Phone:512-280-0999
Mailing Address - Fax:
Practice Address - Street 1:4001 IRIONA BND
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-4913
Practice Address - Country:US
Practice Address - Phone:512-280-0999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-04
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT01993133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered