Provider Demographics
NPI:1407853864
Name:SIMPSON, TERESA (RD, LD, CDE)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 W ARAPAHO RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4049
Mailing Address - Country:US
Mailing Address - Phone:972-498-4500
Mailing Address - Fax:972-680-9147
Practice Address - Street 1:820 W ARAPAHO RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4049
Practice Address - Country:US
Practice Address - Phone:972-498-4500
Practice Address - Fax:972-680-9147
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01196133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B6829Medicare PIN