Active NPI
Houston Duckwall, RDLD
- Registered Dietitian
- Pampa, TX
National Provider Identifier
1265912430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT85411
- Practice address
- One Medical Plaza
Pampa, TX 79065 - Phone
- (806) 665-3721
- Fax
- (806) 663-5655
- NPI assigned
- Aug 17, 2018
- Last updated
- Aug 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT85411 | TX | Primary |
Addresses
Primary practice location
One Medical Plaza
Pampa, TX 79065
Mailing address
3023 Perryton Pkwy Ste 101
Pampa, TX 79065-2817
Phone (806) 665-0801
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86069871 | Other | COMMISSION ON DIETETIC REGISTRATION | |
| DT85411 | Other | TX | TEXAS DEPT OF LICENSING AND REGULATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT85411 | TX | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534464000000",
"number": "1265912430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3023 PERRYTON PKWY STE 101",
"city": "PAMPA",
"state": "TX",
"postal_code": "790652817",
"telephone_number": "806-665-0801",
"fax_number": "806-665-8503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE MEDICAL PLAZA",
"city": "PAMPA",
"state": "TX",
"postal_code": "79065",
"telephone_number": "806-665-3721",
"fax_number": "806-663-5655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCKWALL",
"first_name": "HOUSTON",
"credential": "RDLD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-17",
"last_updated": "2018-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT85411",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMISSION ON DIETETIC REGISTRATION",
"identifier": "86069871",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS DEPT OF LICENSING AND REGULATION",
"identifier": "DT85411",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pampa, TX
- Deer Land Emergency Physicians PLLC
- Ralph Depee, DDS
- Ryan Dimel
- Kaylynn Beth Downs, FNP-C
- DRS Simmons and Simmons, PA
- Krista Michele Eaton, PTA
- Emergency Services Foundation of Texas (Genesis Clinic)
- Emergency Services Foundation of Texas, Inc. (Pampa EMS)
- Alyssa Escamilla, FNP-C
- Family Med Now, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.