Provider Demographics
NPI:1609438118
Name:TORRES, LAURA (RDN, LD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-5220
Mailing Address - Country:US
Mailing Address - Phone:512-942-7126
Mailing Address - Fax:
Practice Address - Street 1:306 E MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5220
Practice Address - Country:US
Practice Address - Phone:512-942-7126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84653133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered