MEDICARE: CHRISTINE DIANE POSPISIL RD

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
1	133V00000X	Registered Dietitian	DT05468	TX

General Provider Information

NPI Number	:	1730128141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE DIANE POSPISIL RD

Provider Business Mailing Address
First Line	:	11321 FALLBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4232
Country	:	US
Telephone Number	:	832-237-3500
Fax Number	:	832-237-0200

Provider Business Practice Location Address
First Line	:	11321 FALLBROOK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-4232
Country	:	US
Telephone Number	:	832-237-3500
Fax Number	:	832-237-0200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	07/08/2007

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Directions to “ CHRISTINE DIANE POSPISIL RD” Practice Location

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