NPI age
19 years
Enumerated 2006-08-05
Across 5402 active dietitian, registered providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | BCBS | 0095KM |
| 01 (TX) | DT06818 | DIETITION LICENSE |
| 01 (TX) | 803193 | CERTIFIED DIETETIC REG. |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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