Provider Demographics
NPI:1154702694
Name:OUDIE, KATERINA MARIE (MS, RD, LD, CSOWM)
Entity type:Individual
Prefix:MRS
First Name:KATERINA
Middle Name:MARIE
Last Name:OUDIE
Suffix:
Gender:F
Credentials:MS, RD, LD, CSOWM
Other - Prefix:
Other - First Name:KATERINA
Other - Middle Name:MARIE
Other - Last Name:BRINLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD, CNSC
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:GENERAL SURGERY/BARIATRIC CLINIC
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-539-3663
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR DEPT OF
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-539-9582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82509133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered