Provider Demographics
NPI:1770757684
Name:RORSCHACH, ANDREW M (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:RORSCHACH
Suffix:
Gender:M
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:PO BOX 22289
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77227-2289
Mailing Address - Country:US
Mailing Address - Phone:832-785-7481
Mailing Address - Fax:
Practice Address - Street 1:1700 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-5827
Practice Address - Country:US
Practice Address - Phone:713-571-6674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT04295133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal