Provider Demographics
NPI:1295986941
Name:FORD, KAREN CHRISTINA (RD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:CHRISTINA
Last Name:FORD
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 1:141 GRANITE PATH
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-4366
Mailing Address - Country:US
Mailing Address - Phone:512-909-9438
Mailing Address - Fax:
Practice Address - Street 1:141 GRANITE PATH
Practice Address - Street 2:
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642-4366
Practice Address - Country:US
Practice Address - Phone:512-909-9438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
TXDT80987133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered