Provider Demographics
NPI:1194007948
Name:CLP MEDICAL NUTRITION COUNSELING OF HARLINGEN
Entity Type:Organization
Organization Name:CLP MEDICAL NUTRITION COUNSELING OF HARLINGEN
Other - Org Name:CARMEN LLERANDI PH IPPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LLERANDI PHIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RD, LD, AHCFA
Authorized Official - Phone:951-233-0026
Mailing Address - Street 1:PO BOX 532521
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78553-2521
Mailing Address - Country:US
Mailing Address - Phone:951-233-0026
Mailing Address - Fax:
Practice Address - Street 1:1911 LUBBOCK ST STE C
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8235
Practice Address - Country:US
Practice Address - Phone:956-444-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty