| NPI | 1831603232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARRIE SUE ITZ-THOMPSON Owner 210-822-5959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT07241) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: TX DT07241) |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2018-03-27 |