Provider Demographics
NPI:1295826121
Name:ORR, SUE (MED, RD, CSG, LD)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:ORR
Suffix:
Gender:F
Credentials:MED, RD, CSG, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9903 WINDING OAK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-3830
Mailing Address - Country:US
Mailing Address - Phone:512-914-1402
Mailing Address - Fax:
Practice Address - Street 1:9903 WINDING OAK CRICLE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3830
Practice Address - Country:US
Practice Address - Phone:512-914-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX542595133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered