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1154590503
DIANA R LOUDENBACK
FORT WORTH, TX
NPI
1154590503
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: TX DT04141)
Enumeration Date
2008-02-29
Last Update Date
2008-02-29
Business Address
MRS. DIANA R LOUDENBACK RD/LD
1500 S MAIN ST
FORT WORTH, TX 76104-4917
Phone number: 817-920-6734
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Mailing Address
MRS. DIANA R LOUDENBACK RD/LD
1400 S MAIN ST SUITE 300
FORT WORTH, TX 76104-4909
Phone number: 817-920-6738
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