Healthcare Provider Details

I. General information

NPI: 1194820050
Provider Name (Legal Business Name): RACHEL TRISTAN RIANO R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 TREASURE HILLS BLVD SUITE B5
HARLINGEN TX
78550-8907
US

IV. Provider business mailing address

2129 SUMMERFIELD LN
HARLINGEN TX
78550-3575
US

V. Phone/Fax

Practice location:
  • Phone: 956-366-4500
  • Fax: 956-366-4501
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT07182
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: