Healthcare Provider Details

I. General information

NPI: 1629773064
Provider Name (Legal Business Name): CLARISSA ORONA BS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5111 CANYON DR
AMARILLO TX
79110-3037
US

IV. Provider business mailing address

5111 CANYON DR
AMARILLO TX
79110-3037
US

V. Phone/Fax

Practice location:
  • Phone: 806-212-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number628422
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: