Individual
MRS. DIANA R LOUDENBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 920-6734
(817) 920-6743
Mailing address
1400 S MAIN ST, SUITE 300, FORT WORTH, TX 76104-4909
(817) 920-6738
(817) 920-6743
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT04141
TX
Other
Enumeration date
02/29/2008
Last updated
02/29/2008
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