| Doctor Name: | MR. DEMETRIUS JERMAINE WILLIS |
| NPI Number: | 1508098567 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MBA, MS, RD, LD, CPT |
| License Number: | DT81138 |
| Business Practice Address: | 225 E Sonterra Blvd San Antonio, TX - 782583992 |
| Business Phone Number: | 2104772799 |
| Business Fax Number: | |
| Mailing Address: | 6422 Merlin Way, SAN ANTONIO |
| State: | TX |
| Postal Code: | 782334661 |
| Phone Number: | 1210485841 |
| Fax Number: | |
| NPI Enumeration Date: | 08/10/2009 |
| NPI Last Update Date: | 08/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | DT81138 |
| 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 |