Individual
HOUSTON DUCKWALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDLD
Contact information
Practice address
ONE MEDICAL PLAZA, PAMPA, TX 79065
(806) 665-3721
(806) 663-5655
Mailing address
3023 PERRYTON PKWY STE 101, PAMPA, TX 79065-2817
(806) 665-0801
(806) 665-8503
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT85411
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86069871
COMMISSION ON DIETETIC REGISTRATION
—
01
—
DT85411
TEXAS DEPT OF LICENSING AND REGULATION
TX
Enumeration date
08/17/2018
Last updated
08/17/2018
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