Provider Demographics
NPI:1487984225
Name:OVIEDO, RAQUEL ANN (MS,RD,LD)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:ANN
Last Name:OVIEDO
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 1:521 E AVE C
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363-3811
Mailing Address - Country:US
Mailing Address - Phone:361-720-5312
Mailing Address - Fax:361-720-5312
Practice Address - Street 1:521 E AVE C
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-3811
Practice Address - Country:US
Practice Address - Phone:361-455-1318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2017-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07297133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered