Healthcare Provider Details

I. General information

NPI: 1033344262
Provider Name (Legal Business Name): WALK THE TALK AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 SAN FELIPE RD SUITE 500
HOUSTON TX
77057-1950
US

IV. Provider business mailing address

PO BOX 571950
HOUSTON TX
77257-1950
US

V. Phone/Fax

Practice location:
  • Phone: 713-706-6103
  • Fax: 713-706-6301
Mailing address:
  • Phone: 713-706-6103
  • Fax: 713-706-6301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT80092
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License NumberDT80092
License Number StateTX

VIII. Authorized Official

Name: MRS. DORCAS UKPE
Title or Position: PRESIDENT & CEO
Credential:
Phone: 713-706-6103