Provider Demographics
NPI:1558648436
Name:CHATTERJEE, SHARMILA (RD, CDE, LDN)
Entity type:Individual
Prefix:MS
First Name:SHARMILA
Middle Name:
Last Name:CHATTERJEE
Suffix:
Gender:F
Credentials:RD, CDE, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST
Mailing Address - Street 2:MSB 3.286
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:847-977-1040
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST STE 350
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3004
Practice Address - Country:US
Practice Address - Phone:847-977-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT90522133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT90522OtherTEXAS DEPARTMENT OF LICENSING & REGULATION
IL164005548OtherSTATE LICENSE