MEDICARE: MS. LAURA WALKER MS,RD, CDN, CDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	007510	NY
2	133V00000X	Registered Dietitian	1033512	NY
3	133V00000X	Registered Dietitian	DT84707	TX
4	163WD0400X	Diabetes Educator Registered Nurse	DT84707	TX

General Provider Information

NPI Number	:	1124394994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA WALKER MS,RD, CDN, CDE

Provider Business Mailing Address
First Line	:	1401 LAVACA ST UNIT 7032
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1634
Country	:	US
Telephone Number	:	512-798-8917
Fax Number	:	512-265-9012

Provider Business Practice Location Address
First Line	:	1401 LAVACA ST UNIT 7032
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1634
Country	:	US
Telephone Number	:	512-798-8917
Fax Number	:	512-265-3012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	06/23/2025

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