Provider Demographics
NPI:1508261215
Name:BAUMAN, WHITNEY (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 COUNTY ROAD 222
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-3257
Mailing Address - Country:US
Mailing Address - Phone:903-941-1113
Mailing Address - Fax:
Practice Address - Street 1:2900 COUNTY ROAD 222
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-3257
Practice Address - Country:US
Practice Address - Phone:903-941-1113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83415133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered