Healthcare Provider Details

I. General information

NPI: 1699883835
Provider Name (Legal Business Name): ANNE FRANCES FARRIS R.D.,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10878 FM 822
EDNA TX
77957-5040
US

IV. Provider business mailing address

10878 FM 822
EDNA TX
77957-5040
US

V. Phone/Fax

Practice location:
  • Phone: 361-782-0139
  • Fax:
Mailing address:
  • Phone: 361-782-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number013123
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: