Provider Demographics
NPI:1598417172
Name:TEXAS FAMILY NUTRITION LLC
Entity Type:Organization
Organization Name:TEXAS FAMILY NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:HANNAH
Authorized Official - Last Name:BROWNLEE KURITA
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:210-294-5415
Mailing Address - Street 1:1064 VANCE JACKSON RD PO BOX 100746
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-8201
Mailing Address - Country:US
Mailing Address - Phone:210-294-5415
Mailing Address - Fax:210-525-0174
Practice Address - Street 1:65 VAUGHAN PL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-3805
Practice Address - Country:US
Practice Address - Phone:210-294-5415
Practice Address - Fax:210-525-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1396387999OtherNPI 1