Provider Demographics
NPI:1922264001
Name:COMPTON, KARA MACKEY (RD, LD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:MACKEY
Last Name:COMPTON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 S AMMERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EASTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:76448-3202
Mailing Address - Country:US
Mailing Address - Phone:405-880-7191
Mailing Address - Fax:
Practice Address - Street 1:304 S DAUGHERTY AVE
Practice Address - Street 2:
Practice Address - City:EASTLAND
Practice Address - State:TX
Practice Address - Zip Code:76448-2609
Practice Address - Country:US
Practice Address - Phone:254-629-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80709133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered