Provider Demographics
NPI:1154004158
Name:RANGEL, DIANA MARIE (RDN)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:RANGEL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11616 PETERS RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79927-3229
Mailing Address - Country:US
Mailing Address - Phone:915-261-5629
Mailing Address - Fax:
Practice Address - Street 1:9541 PLAZA CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79927-2005
Practice Address - Country:US
Practice Address - Phone:915-213-2941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88854133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty