MEDICARE: LEILANI BAYER M.S., R.D.N., L.D.

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
1	133V00000X	Registered Dietitian	DT83550	TX

General Provider Information

NPI Number	:	1326430034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEILANI BAYER M.S., R.D.N., L.D.

Provider Business Mailing Address
First Line	:	2219 SAWDUST RD STE 904
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-2580
Country	:	US
Telephone Number	:	844-532-7623
Fax Number	:	888-256-7796

Provider Business Practice Location Address
First Line	:	395 SAWDUST RD STE 2025
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-2242
Country	:	US
Telephone Number	:	844-532-7623
Fax Number	:	888-256-7796

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2015
Last Update Date	:	03/04/2015

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