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Individual

MRS. BECKY LYNN KUBICEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD LD

Contact information

Practice address
600 N PARK ST, BRENHAM, TX 77833-2610
(979) 337-5800
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT03857
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
727176
COMMISSION ON DIETETIC RG
Enumeration date
11/15/2006
Last updated
12/09/2020
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