Provider Demographics
NPI:1568102911
Name:ROWE, MARIA (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 ZIMMERMAN LN
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1875
Mailing Address - Country:US
Mailing Address - Phone:512-963-8595
Mailing Address - Fax:
Practice Address - Street 1:1705 ZIMMERMAN LN
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-1875
Practice Address - Country:US
Practice Address - Phone:512-963-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87645133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered