Aisha Lisette Patrick, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT88685 Issued in TX

Practice address

590 Medical Center Road
2ND Floor, Wetlands, Suite a
Fort Cavazos, TX 76544

Phone

(254) 553-4463

NPI assigned

Oct 3, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1831979244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 MEDICAL CENTER ROAD",
            "city": "FT CAVAZOS",
            "state": "TX",
            "postal_code": "76544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 MEDICAL CENTER ROAD",
            "address_2": "2ND FLOOR, WETLANDS, SUITE A",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-553-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "AISHA",
        "middle_name": "LISETTE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT88685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gen Bohm Paek, D.D.S.
• Mavis Ho Park, DDS
• Rodney Parker, RN
• Hayden Anthony Pastorini, DO
• Tapan Patel, PT
• Nathan Allen Payne, DMD
• Justin G Perdue, MD
• Matthew Perdue, PA
• Jessica Perez, PHD
• Scott Collin Petersen, MD

• Registered Dietitian in Fort Cavazos, TX
• Providers in Fort Cavazos, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.