Provider Demographics
NPI:1831252139
Name:BECKER, KRISTY ROGERS (MS, RD, LD, CNSC)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:ROGERS
Last Name:BECKER
Suffix:
Gender:F
Credentials:MS, RD, LD, CNSC
Other - Prefix:MS
Other - First Name:KRISTY
Other - Middle Name:RENEE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:2002 HOLCOMBE BLVD
Mailing Address - Street 2:MICHAEL E. DEBAKEY VA MEDICAL CENTER
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-791-1414
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:MICHAEL E. DEBAKEY VA MEDICAL CENTER
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:713-794-7448
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133V00000X
TXDT06872133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered