Provider Demographics
NPI:1548876410
Name:BARRERA, ANAFERNANDA (RD, LD)
Entity type:Individual
Prefix:MISS
First Name:ANAFERNANDA
Middle Name:
Last Name:BARRERA
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 LAGUNA DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-7312
Mailing Address - Country:US
Mailing Address - Phone:972-955-3863
Mailing Address - Fax:
Practice Address - Street 1:930 LAGUNA DR
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7312
Practice Address - Country:US
Practice Address - Phone:972-955-3863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86539133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty