Provider Demographics
NPI:1558896928
Name:WORLEY, MARIA ANNETTE (RDN, LD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANNETTE
Last Name:WORLEY
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:ANNETTE
Other - Last Name:REGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:13507 PUEBLO SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-6100
Mailing Address - Country:US
Mailing Address - Phone:210-859-9555
Mailing Address - Fax:
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-859-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDTO05538133V00000X
IL706232133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered