Provider Demographics
NPI:1275601510
Name:LOVE, KRISTEN RENE (RD)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:RENE
Last Name:LOVE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 BROMPTON ST
Mailing Address - Street 2:#4614
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-2180
Mailing Address - Country:US
Mailing Address - Phone:713-349-9729
Mailing Address - Fax:
Practice Address - Street 1:4500 BLALOCK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-9121
Practice Address - Country:US
Practice Address - Phone:713-934-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07501133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G2115Medicare ID - Type Unspecified
TX259152Medicare UPIN