Provider Demographics
NPI:1952461543
Name:HARRINGTON, EDWARD R (RD LD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:R
Last Name:HARRINGTON
Suffix:
Gender:M
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:PO BOX 4650
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78523
Mailing Address - Country:US
Mailing Address - Phone:956-546-3116
Mailing Address - Fax:956-546-8793
Practice Address - Street 1:425 E LOS EBANOS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-546-3116
Practice Address - Fax:956-546-8793
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05965133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J1440Medicare PIN