Healthcare Provider Details

I. General information

NPI: 1538801733
Provider Name (Legal Business Name): ANNA M ALFRED RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W SAM HOUSTON PKWY S
HOUSTON TX
77042-2447
US

IV. Provider business mailing address

6901 BACKSTROM ST
HITCHCOCK TX
77563-3705
US

V. Phone/Fax

Practice location:
  • Phone: 888-344-4549
  • Fax: 908-652-9230
Mailing address:
  • Phone: 304-373-3817
  • Fax: 908-652-9230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number86143643
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: