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General NPI Number Information
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NPI Number | 1841577608
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Entity Type | Individual
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Provider Name | SANDRA R WYERS MS, RDN
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Gender | Female
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 06/19/2022
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Provider Practice Location Address
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Address Line | 2900 W ANDERSON LN STE C-200354
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City | AUSTIN
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State | TX
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Zip | 78757-1102
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Country | US
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Telephone | 512-643-3761
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Fax | 737-282-0615
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Provider Business Mailing Address
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Address Line | 912 BANYON ST UNIT B
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City | AUSTIN
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State | TX
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Zip | 78757-1506
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Country | US
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Telephone | 512-878-0464
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT82734
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License Number State | TX
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