Provider Demographics
NPI:1295242402
Name:LARKIN, STACI MICHELLE (RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:STACI
Middle Name:MICHELLE
Last Name:LARKIN
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 WINDING LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5726
Mailing Address - Country:US
Mailing Address - Phone:281-886-4024
Mailing Address - Fax:
Practice Address - Street 1:21700 BELLAIRE BLVD STE 1520
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-3913
Practice Address - Country:US
Practice Address - Phone:361-298-0920
Practice Address - Fax:833-706-9444
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82944133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered