Provider Demographics
NPI:1841838810
Name:EVERETT, CATHERINE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:EVERETT
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 AVONDALE ST APT 8
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-3337
Mailing Address - Country:US
Mailing Address - Phone:662-312-7355
Mailing Address - Fax:
Practice Address - Street 1:109 AVONDALE ST APT 8
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3337
Practice Address - Country:US
Practice Address - Phone:662-312-7355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86068468133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty