Provider Demographics
NPI:1609347038
Name:RAYMOND, ANNETTE MARIE (RDN REGISTERED DI)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:MARIE
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:RDN REGISTERED DI
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD REGISTERED DIET
Mailing Address - Street 1:1059 RACELAND RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245
Mailing Address - Country:US
Mailing Address - Phone:832-660-3055
Mailing Address - Fax:
Practice Address - Street 1:1 GAMBREL OAK PL
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3821
Practice Address - Country:US
Practice Address - Phone:832-660-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered