MEDICARE: AIMEE ELIZABETH SENIOR RDN, LD

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	DT83404	TX

General Provider Information

NPI Number	:	1609225333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE ELIZABETH SENIOR RDN, LD

Provider Business Mailing Address
First Line	:	14439 NW MILITARY HWY
Second Line	:	STE 108 BOX 471
City	:	SAN ANTONIO
State	:	TX
Zip	:	78231
Country	:	US
Telephone Number	:	409-658-5028
Fax Number	:

Provider Business Practice Location Address
First Line	:	11107 WURZBACH RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2500
Country	:	US
Telephone Number	:	210-920-0669
Fax Number	:

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

Provider Enumeration Date	:	06/03/2016
Last Update Date	:	01/20/2026

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