Provider Demographics
NPI:1326375528
Name:OWENS, SOMMER RAINWATER (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:SOMMER
Middle Name:RAINWATER
Last Name:OWENS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:SOMMER
Other - Middle Name:
Other - Last Name:RAINWATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:3259 COOKSEY LN
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:TX
Mailing Address - Zip Code:76706-7107
Mailing Address - Country:US
Mailing Address - Phone:254-717-7777
Mailing Address - Fax:
Practice Address - Street 1:100 HILLCREST MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8897
Practice Address - Country:US
Practice Address - Phone:254-717-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX980195133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered