Provider Demographics
NPI:1003572058
Name:FRAZIER, EMILY CAIN (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CAIN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 LAVENDER HAZE PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-6409
Mailing Address - Country:US
Mailing Address - Phone:936-273-0226
Mailing Address - Fax:
Practice Address - Street 1:59 LAVENDER HAZE PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-6409
Practice Address - Country:US
Practice Address - Phone:936-273-0226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX876597133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered