Provider Demographics
NPI:1720692213
Name:HOBBS, KATHRYN (RD, LD, IBCLC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:HOBBS
Suffix:
Gender:F
Credentials:RD, LD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6034 W COURTYARD DR STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-5064
Mailing Address - Country:US
Mailing Address - Phone:512-328-2266
Mailing Address - Fax:512-328-2055
Practice Address - Street 1:345 CYPRESS CREEK RD STE 104
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4484
Practice Address - Country:US
Practice Address - Phone:512-336-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-156999174N00000X
TX86020270133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN