Provider Demographics
NPI:1720338817
Name:AGUIRRE, NELDA A (MS,RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:NELDA
Middle Name:A
Last Name:AGUIRRE
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 1:13107 PARKBROOK WAY LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7473
Mailing Address - Country:US
Mailing Address - Phone:281-723-5005
Mailing Address - Fax:281-240-2895
Practice Address - Street 1:13107 PARKBROOK WAY LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7473
Practice Address - Country:US
Practice Address - Phone:281-723-5005
Practice Address - Fax:281-240-2895
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-15
Last Update Date:2012-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT01122133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered