Ms Detria Latasha Branch, MS, RDN, RHNC is a
Dietitian, Registered based in El Paso, Texas. Ms Detria Latasha Branch is licensed to practice in Texas (license number DT88116) and her current practice location is
10208 Bon Aire Dr, El Paso, Texas. She can be reached at her office (for appointments etc.) via phone at
(888) 474-4486.
NPI number for Ms Detria Latasha Branch is 1790300259 and her current mailing address is 10208 Bon Aire Dr, El Paso, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1790300259.
Healthcare Provider's Profile
| Full Name | Ms Detria Latasha Branch |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 10208 Bon Aire Dr, El Paso, Texas |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1790300259
- Provider Enumeration Date: 06/10/2020
- Last Update Date: 06/11/2023
Medical Identifiers
Medical identifiers for Ms Detria Latasha Branch such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790300259 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 133N00000X | Nutritionist | (* (Not Available)) | Secondary |
| 133NN1002X | Nutritionist - Nutrition, Education | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | LD2023085 (New Mexico) | Secondary |
| 174H00000X | Health Educator | (* (Not Available)) | Secondary |
| 261QG0250X | Clinic/center - Genetics | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | DT88116 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Detria Latasha Branch is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Detria Latasha Branch, MS, RDN, RHNC
10208 Bon Aire Dr,
El Paso, TX 79924-2936
Ph: (505) 417-0036 | Ms Detria Latasha Branch, MS, RDN, RHNC
10208 Bon Aire Dr,
El Paso, TX 79924-2936
Ph: (888) 474-4486 |
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