Provider Demographics
NPI:1457776593
Name:HOBSON, KIM (RD/LD)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HOBSON
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 1:3614 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2868
Mailing Address - Country:US
Mailing Address - Phone:214-732-2830
Mailing Address - Fax:
Practice Address - Street 1:3614 CARRINGTON DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-2868
Practice Address - Country:US
Practice Address - Phone:214-732-2830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05751133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered