Provider Demographics
NPI:1477824860
Name:WATSON, CHER CHRISTINA (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:CHER
Middle Name:CHRISTINA
Last Name:WATSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LD
Mailing Address - Street 1:107 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-4609
Mailing Address - Country:US
Mailing Address - Phone:979-532-1278
Mailing Address - Fax:979-532-1278
Practice Address - Street 1:107 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-4609
Practice Address - Country:US
Practice Address - Phone:979-532-1278
Practice Address - Fax:979-532-1278
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05683133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered