Provider Demographics
NPI:1215495247
Name:PATTISON, SARAH (RDN, LD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PATTISON
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-5609
Mailing Address - Country:US
Mailing Address - Phone:512-710-5650
Mailing Address - Fax:
Practice Address - Street 1:2201 HOLLY ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-5609
Practice Address - Country:US
Practice Address - Phone:512-710-5650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85059133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered