Individual
JANET MARLENE BASOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CSO
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430-0002
(806) 743-3150
(806) 743-3168
Mailing address
PO BOX 5865, LUBBOCK, TX 79408-5865
(806) 743-2898
(806) 743-2787
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
#DT00870
TX
Other
Enumeration date
10/26/2012
Last updated
04/18/2016
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