Provider Demographics
NPI:1003363532
Name:SHROYER, HEATHER (MPH, RDN, LD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SHROYER
Suffix:
Gender:F
Credentials:MPH, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 ED ENGLISH DR STE B
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8019
Mailing Address - Country:US
Mailing Address - Phone:979-966-8028
Mailing Address - Fax:
Practice Address - Street 1:250 ED ENGLISH DR STE B
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8019
Practice Address - Country:US
Practice Address - Phone:979-966-8028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2025-05-30
Deactivation Date:2022-01-12
Deactivation Code:
Reactivation Date:2025-05-30
Provider Licenses
StateLicense IDTaxonomies
TXDT83483133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered