MEDICARE: MS. TATJANA WALKER RDN, LDN, 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	133VN1006X	Metabolic Nutrition Registered Dietitian	DT82932	TX

General Provider Information

NPI Number	:	1700252848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TATJANA WALKER RDN, LDN, CDE

Provider Business Mailing Address
First Line	:	264 W MARIPOSA DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-1507
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	264 W MARIPOSA DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-1507
Country	:	US
Telephone Number	:	210-865-8144
Fax Number	:

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

Provider Enumeration Date	:	08/12/2015
Last Update Date	:	08/12/2015

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