| Doctor Name: | JANET MARLENE BASOM |
| NPI Number: | 1356694459 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD, LD, CSO |
| License Number: | #DT00870 |
| Business Practice Address: | 3601 4th St Lubbock, TX - 794300002 |
| Business Phone Number: | 8067433150 |
| Business Fax Number: | 8067433168 |
| Mailing Address: | Po Box 5865, LUBBOCK |
| State: | TX |
| Postal Code: | 794085865 |
| Phone Number: | 8067432898 |
| Fax Number: | 8067432787 |
| NPI Enumeration Date: | 10/26/2012 |
| NPI Last Update Date: | 04/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | #DT00870 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |