Provider Demographics
NPI:1396173738
Name:MARVIN, BROOK (MS, RD/LD)
Entity type:Individual
Prefix:
First Name:BROOK
Middle Name:
Last Name:MARVIN
Suffix:
Gender:F
Credentials:MS, RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 NORTHWEST FWY STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6346
Mailing Address - Country:US
Mailing Address - Phone:832-237-3500
Mailing Address - Fax:281-578-2509
Practice Address - Street 1:11301 FALLBROOK DR STE 304
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4272
Practice Address - Country:US
Practice Address - Phone:713-840-5100
Practice Address - Fax:281-469-9119
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80506133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic