Provider Demographics
NPI:1497526354
Name:HUDSON, BAILEY (RD, LD)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 KEARNEY HILL LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-1692
Mailing Address - Country:US
Mailing Address - Phone:281-755-4127
Mailing Address - Fax:
Practice Address - Street 1:7406 KEARNEY HILL LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-1692
Practice Address - Country:US
Practice Address - Phone:281-755-4127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88031133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered