Provider Demographics
NPI:1538486048
Name:COULTER, CAROLYN KASBEER (RD, LD)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:KASBEER
Last Name:COULTER
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 1:550 WESTLAKE PARK BLVD
Mailing Address - Street 2:ROOM 1067
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2661
Mailing Address - Country:US
Mailing Address - Phone:281-366-0799
Mailing Address - Fax:
Practice Address - Street 1:550 WESTLAKE PARK BLVD
Practice Address - Street 2:ROOM 1067
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-2661
Practice Address - Country:US
Practice Address - Phone:281-366-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81309133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered