Provider Demographics
NPI:1598407710
Name:ALANIS HERRERA, BRENDA ITZEL (DIETITITAN)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:ITZEL
Last Name:ALANIS HERRERA
Suffix:
Gender:F
Credentials:DIETITITAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4416 BLUEBIRD AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6334
Mailing Address - Country:US
Mailing Address - Phone:956-518-0263
Mailing Address - Fax:
Practice Address - Street 1:825 LAKESIDE BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7616
Practice Address - Country:US
Practice Address - Phone:565-464-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist