Provider Demographics
NPI:1215794946
Name:BRIMER, LAURA (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BRIMER
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CATTAIL PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3220
Mailing Address - Country:US
Mailing Address - Phone:512-755-1568
Mailing Address - Fax:
Practice Address - Street 1:2 CATTAIL PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-3220
Practice Address - Country:US
Practice Address - Phone:512-755-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83608133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered