Provider Demographics
NPI:1003388992
Name:COMPOSITION ID HOUSTON, LLC
Entity Type:Organization
Organization Name:COMPOSITION ID HOUSTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:RD,LD
Authorized Official - Phone:832-729-5797
Mailing Address - Street 1:3801 KIRBY DR STE 415
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-4154
Mailing Address - Country:US
Mailing Address - Phone:832-729-5797
Mailing Address - Fax:
Practice Address - Street 1:3801 KIRBY DR STE 415
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-4154
Practice Address - Country:US
Practice Address - Phone:832-729-5797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty