Provider Demographics
NPI:1336545300
Name:TASTE OF LIFE, LLC
Entity Type:Organization
Organization Name:TASTE OF LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:CROW
Authorized Official - Last Name:FEE
Authorized Official - Suffix:
Authorized Official - Credentials:RD LD
Authorized Official - Phone:832-656-7827
Mailing Address - Street 1:14340 TORREY CHASE BLVD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1021
Mailing Address - Country:US
Mailing Address - Phone:281-866-8746
Mailing Address - Fax:281-866-0858
Practice Address - Street 1:14340 TORREY CHASE BLVD
Practice Address - Street 2:SUITE 155
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1021
Practice Address - Country:US
Practice Address - Phone:281-866-8746
Practice Address - Fax:281-866-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07574133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty