Provider Demographics
NPI:1689701161
Name:NUTRITION THERAPY ASSOCIATES, INC
Entity Type:Organization
Organization Name:NUTRITION THERAPY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:KREST
Authorized Official - Last Name:HAMONS GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD
Authorized Official - Phone:210-349-9837
Mailing Address - Street 1:15519 GREY FOX TER
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-1203
Mailing Address - Country:US
Mailing Address - Phone:210-349-9837
Mailing Address - Fax:210-467-5903
Practice Address - Street 1:15519 GREY FOX TER
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-1203
Practice Address - Country:US
Practice Address - Phone:210-349-9837
Practice Address - Fax:210-467-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06530133V00000X, 133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Not Answered133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty