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General NPI Number Information
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NPI Number | 1063676187
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Entity Type | Individual
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Provider Name | LUIS RUSTVELD RD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 3701 KIRBY DR SUITE 100
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City | HOUSTON
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State | TX
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Zip | 77098-3900
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Country | US
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Telephone | 713-798-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 3701 KIRBY DR STE 600
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City | HOUSTON
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State | TX
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Zip | 77098-3926
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Country | US
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Telephone | 713-798-4098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT80780
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License Number State | TX
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