Provider Demographics
NPI:1699883835
Name:FARRIS, ANNE FRANCES (RD,CDE)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:FRANCES
Last Name:FARRIS
Suffix:
Gender:F
Credentials:RD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10878 FM 822
Mailing Address - Street 2:
Mailing Address - City:EDNA
Mailing Address - State:TX
Mailing Address - Zip Code:77957-5040
Mailing Address - Country:US
Mailing Address - Phone:361-782-0139
Mailing Address - Fax:
Practice Address - Street 1:10878 FM 822
Practice Address - Street 2:
Practice Address - City:EDNA
Practice Address - State:TX
Practice Address - Zip Code:77957-5040
Practice Address - Country:US
Practice Address - Phone:361-782-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013123133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192441701Medicaid
TX8K1063Medicare PIN