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General NPI Number Information
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NPI Number | 1598417172
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Entity Type | Organization
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Legal Business Name | TEXAS FAMILY NUTRITION LLC
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 65 VAUGHAN PL
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City | SAN ANTONIO
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State | TX
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Zip | 78201-3805
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Country | US
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Telephone | 210-294-5415
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Fax | 210-525-0174
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Provider Business Mailing Address
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Address Line | 1064 VANCE JACKSON RD PO BOX 100746
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City | SAN ANTONIO
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State | TX
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Zip | 78201-8201
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Country | US
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Telephone | 210-294-5415
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Fax | 210-525-0174
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | RACHEL HANNAH BROWNLEE KURITA
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Credential | RD, LD
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Telephone | 210-294-5415
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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 |
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License Number State |
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