Provider Demographics
NPI:1427180264
Name:LATIMER, DEBRA FERMER (RD,LD,CDE)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:FERMER
Last Name:LATIMER
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 1:6300 WEST LOOP S
Mailing Address - Street 2:SUITE 333
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2900
Mailing Address - Country:US
Mailing Address - Phone:713-795-0876
Mailing Address - Fax:713-432-7989
Practice Address - Street 1:6300 WEST LOOP S
Practice Address - Street 2:SUITE 333
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2900
Practice Address - Country:US
Practice Address - Phone:713-795-0876
Practice Address - Fax:713-432-7989
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT01014133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610395Medicare PIN