Provider Demographics
NPI:1891863775
Name:HARMS, LAURA S (RD, LD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:S
Last Name:HARMS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:S
Other - Last Name:RAPACZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:17937 INTERSTATE 45 S
Mailing Address - Street 2:STE 115
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17937 INTERSTATE 45 S
Practice Address - Street 2:STE 115
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8783
Practice Address - Country:US
Practice Address - Phone:713-840-5280
Practice Address - Fax:936-271-2690
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011005948133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT 84062OtherSTATE LICENSE
TX940838OtherCDR