Provider Demographics
NPI:1114162153
Name:ZIMBICKI, BETHANY L (RD)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:L
Last Name:ZIMBICKI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RIVERWAY
Mailing Address - Street 2:SUITE 825
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1919
Mailing Address - Country:US
Mailing Address - Phone:713-840-5245
Mailing Address - Fax:281-897-9906
Practice Address - Street 1:7863 CALLAGHAN RD
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-2453
Practice Address - Country:US
Practice Address - Phone:832-237-3500
Practice Address - Fax:832-237-0200
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05508133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic