Healthcare Provider Details

I. General information

NPI: 1972820249
Provider Name (Legal Business Name): AMBER M CAPOZZI RD, CSOWM, LD, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMBER M SEEWALD

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20405 STATE HIGHWAY 249 STE 325
HOUSTON TX
77070-2893
US

IV. Provider business mailing address

PO BOX 211699
EAGAN MN
55121-3699
US

V. Phone/Fax

Practice location:
  • Phone: 866-849-0692
  • Fax:
Mailing address:
  • Phone: 866-849-0692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164009689
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT84153
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: