Healthcare Provider Details

I. General information

NPI: 1194643643
Provider Name (Legal Business Name): CHRISTEN L SPEARS NTP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 BLUEBONNET LN UNIT 209
AUSTIN TX
78704-4048
US

IV. Provider business mailing address

2021 BLUEBONNET LN UNIT 209
AUSTIN TX
78704-4048
US

V. Phone/Fax

Practice location:
  • Phone: 210-392-1134
  • Fax:
Mailing address:
  • Phone: 210-392-1134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number9605
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: