Provider Demographics
NPI:1134141955
Name:BACHMEYER, MARY (RD,LD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:BACHMEYER
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 1:7501 LAKEVIEW PKWY
Mailing Address - Street 2:STE 270
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-9329
Mailing Address - Country:US
Mailing Address - Phone:972-412-7700
Mailing Address - Fax:972-412-7710
Practice Address - Street 1:1005 W RALPH M HALL PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6658
Practice Address - Country:US
Practice Address - Phone:972-771-9081
Practice Address - Fax:972-772-7102
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01577133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered