Provider Demographics
NPI:1104534304
Name:MOYEDA CARABAZA, ANA FLORENCIA (PHD, RDN, LD, LMNT)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:FLORENCIA
Last Name:MOYEDA CARABAZA
Suffix:
Gender:F
Credentials:PHD, RDN, LD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 CAVITT CT
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-4815
Mailing Address - Country:US
Mailing Address - Phone:806-548-7994
Mailing Address - Fax:
Practice Address - Street 1:405 LONDONDERRY DR STE 310
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7922
Practice Address - Country:US
Practice Address - Phone:254-751-4097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT89982133V00000X
NE1640133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered