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General NPI Number Information
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NPI Number | 1114301546
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Entity Type | Individual
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Provider Name | KATIA VEGA RDN
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Gender | Female
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 1805 RUBEN TORRES BLVD STE B29A
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City | BROWNSVILLE
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State | TX
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Zip | 78521-1115
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Country | US
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Telephone | 956-546-4898
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Fax | 956-517-1015
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Provider Business Mailing Address
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Address Line | 1701 LOVETT RD
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City | SAN BENITO
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State | TX
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Zip | 78586-4904
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Country | US
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Telephone | 956-517-5805
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Fax | 956-517-1015
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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 | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 86056187
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License Number State | TX
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