Provider Demographics
NPI:1689341646
Name:IBANEZ, CATHERINE (RD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:IBANEZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3367
Mailing Address - Country:US
Mailing Address - Phone:956-878-5081
Mailing Address - Fax:
Practice Address - Street 1:1811 N 23RD ST STE 125
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8550
Practice Address - Country:US
Practice Address - Phone:956-877-9613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86890133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered