Individual
DENISE CAROL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.D.E.
Contact information
Practice address
800 5TH AVE, SUITE 300, FORT WORTH, TX 76104-7300
(817) 334-1400
(817) 334-1410
Mailing address
9003 AIRPORT FWY, SUITE 300, NORTH RICHLAND HILLS, TX 76180-7770
(817) 514-5200
(817) 514-5210
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
319222
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8K2932
MEDICARE ID, UNSPECIFIED
TX
01
—
8K2933
MEDICARE ID, UNSPECIFIED
TX
01
—
8K2934
MEDICARE ID, UNSPECIFIED
TX
01
—
ON53610
MEDICARE NUMBER, MICHIGAN
MI
Enumeration date
11/07/2007
Last updated
03/17/2009
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