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NPI Code Detail

MEDICARE: LATINA KIDNEY DIETITIAN LLC

MEDICARE: LATINA KIDNEY DIETITIAN LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1073390142
Entity Type Code : Organization
Provider Name (Legal Business Name) : LATINA KIDNEY DIETITIAN LLC
Provider Business Mailing Address
First Line : 7619 TYLER CREEK LN
Second Line :
City : HUMBLE
State : TX
Zip : 77396-6065
Country : US
Telephone Number : 956-495-7595
Fax Number :
Provider Business Practice Location Address
First Line : 2180 NORTH LOOP W STE 120
Second Line :
City : HOUSTON
State : TX
Zip : 77018-8014
Country : US
Telephone Number : 956-495-7595
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ARELI GUTIERREZ
Credential : MS RD LD
Telephone Number : 956-495-7595
Provider Enumeration Date : 09/12/2023
Last Update Date : 02/27/2026

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Directions to “LATINA KIDNEY DIETITIAN LLC ” Practice Location

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