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NPI Code Detail

MEDICARE: BRENDA LEE ALCARAZ-NIEVES

MEDICARE: BRENDA LEE ALCARAZ-NIEVES
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 DietitianDT83684TX

General Provider Information

NPI Number : 1972008506
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA LEE ALCARAZ-NIEVES
Provider Business Mailing Address
First Line : 2800 SHORELINE DR STE 120
Second Line :
City : DENTON
State : TX
Zip : 76210-0130
Country : US
Telephone Number : 855-383-1240
Fax Number : 855-383-1241
Provider Business Practice Location Address
First Line : 2800 SHORELINE DR STE 120
Second Line :
City : DENTON
State : TX
Zip : 76210-0130
Country : US
Telephone Number : 855-383-1240
Fax Number : 855-383-1241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2018
Last Update Date : 03/26/2018

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Directions to “ BRENDA LEE ALCARAZ-NIEVES ” Practice Location

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