Provider Demographics
NPI:1720719016
Name:FLORES, VICTORIA NATALIA (RD , LD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:NATALIA
Last Name:FLORES
Suffix:
Gender:F
Credentials:RD , LD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:NATALIA
Other - Last Name:WHITEHEAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, LD
Mailing Address - Street 1:12436 FM 1960 RD W. #445
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065
Mailing Address - Country:US
Mailing Address - Phone:281-803-9235
Mailing Address - Fax:
Practice Address - Street 1:4800 CALHOUN RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77204
Practice Address - Country:US
Practice Address - Phone:281-803-9235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-18
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86210133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered