Provider Demographics
NPI:1568246197
Name:BROWN, CALEB (RD)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5126 N LOOP 1604 E APT 8304
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-5963
Mailing Address - Country:US
Mailing Address - Phone:210-563-5812
Mailing Address - Fax:
Practice Address - Street 1:5126 N LOOP 1604 E APT 8304
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-5963
Practice Address - Country:US
Practice Address - Phone:210-563-5812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered