Provider Demographics
NPI:1316668957
Name:FERRELL, CARLA DENISE (RD)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:DENISE
Last Name:FERRELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5006 AUTUMN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-5002
Mailing Address - Country:US
Mailing Address - Phone:713-252-1621
Mailing Address - Fax:
Practice Address - Street 1:16403 SALINAS LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-3915
Practice Address - Country:US
Practice Address - Phone:713-252-1621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06436133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered