Provider Demographics
NPI:1326217597
Name:TOM, KATHERINE N (MS, RD, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:N
Last Name:TOM
Suffix:
Gender:F
Credentials:MS, RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 REDWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-6103
Mailing Address - Country:US
Mailing Address - Phone:214-884-5201
Mailing Address - Fax:214-276-7503
Practice Address - Street 1:1021 REDWOOD TRL
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-6103
Practice Address - Country:US
Practice Address - Phone:214-884-5201
Practice Address - Fax:214-276-7503
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered