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General NPI Number Information
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NPI Number | 1639905714
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Entity Type | Organization
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Legal Business Name | VICTOREM, LLC
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 07/11/2026
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Provider Practice Location Address
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Address Line | 3450 STUART RD
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City | BRENHAM
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State | TX
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Zip | 77833-1788
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Country | US
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Telephone | 979-213-7308
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 STUART RD
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City | BRENHAM
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State | TX
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Zip | 77833-1788
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Country | US
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Telephone | 979-574-4388
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Fax |
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Authorized Official
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Title or Position | OWNER, REGISTERED DIETITIAN
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Name | JENA LEE BROWN
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Credential | RD, CSSD, LD
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Telephone | 979-574-4388
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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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