Healthcare Provider Details

I. General information

NPI: 1598638702
Provider Name (Legal Business Name): ANNA KATHRYN YEAKEY RD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 SOUTHWEST FWY STE 2100
HOUSTON TX
77027-7525
US

IV. Provider business mailing address

5213 GIBSON ST
HOUSTON TX
77007-5261
US

V. Phone/Fax

Practice location:
  • Phone: 833-208-7770
  • Fax:
Mailing address:
  • Phone: 903-948-3405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT88098
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: