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NPI Code Detail

MEDICARE: IRENE VIELMA

MEDICARE: IRENE VIELMA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDT86141TX

General Provider Information

NPI Number : 1003404021
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENE VIELMA
Provider Business Mailing Address
First Line : 9415 MCNEIL DR APT 918
Second Line :
City : AUSTIN
State : TX
Zip : 78750-8568
Country : US
Telephone Number : 830-513-9882
Fax Number :
Provider Business Practice Location Address
First Line : 250 UNIVERSITY BLVD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78665-1044
Country : US
Telephone Number : 830-513-9882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2021
Last Update Date : 01/05/2021

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Directions to “ IRENE VIELMA ” Practice Location

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