Provider Demographics
NPI:1669067781
Name:GERMAN, SOPHIE P (RD)
Entity type:Individual
Prefix:MS
First Name:SOPHIE
Middle Name:P
Last Name:GERMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3503 FAWN CREEK PATH
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1459
Mailing Address - Country:US
Mailing Address - Phone:512-663-7240
Mailing Address - Fax:
Practice Address - Street 1:11851 JOLLYVILLE RD STE 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-2350
Practice Address - Country:US
Practice Address - Phone:512-257-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered