Healthcare Provider Details

I. General information

NPI: 1184089112
Provider Name (Legal Business Name): CARLI VOGLER RD LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2015
Last Update Date: 12/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 RICHMOND AVE STE 275
HOUSTON TX
77006-5560
US

IV. Provider business mailing address

701 RICHMOND AVE STE 275
HOUSTON TX
77006-5560
US

V. Phone/Fax

Practice location:
  • Phone: 832-544-0101
  • Fax: 832-559-0700
Mailing address:
  • Phone: 832-544-0101
  • Fax: 832-559-0700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberDT83990
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: