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NPI Code Detail

MEDICARE: MRS. CHRISTINE ELIZABETH MARQUETTE R.D., L.D.

MEDICARE: MRS. CHRISTINE ELIZABETH MARQUETTE R.D., L.D.
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
1133V00000XRegistered DietitianDT06469TX
2133V00000XRegistered Dietitian912732TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DT06469OTHERTXLICENSED DIETITIAN NUMBER
2912732OTHERREGISTERED DIETITIAN

General Provider Information

NPI Number : 1609887496
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINE ELIZABETH MARQUETTE R.D., L.D.
Provider Business Mailing Address
First Line : 4614 N IH 35
Second Line :
City : AUSTIN
State : TX
Zip : 78751-3401
Country : US
Telephone Number : 512-978-9100
Fax Number : 512-901-9751
Provider Business Practice Location Address
First Line : 4614 N IH 35
Second Line :
City : AUSTIN
State : TX
Zip : 78751-3401
Country : US
Telephone Number : 512-978-9100
Fax Number : 512-901-9751
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 03/13/2017

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