Provider Demographics
NPI:1801286331
Name:ALAMO NUTRITION CONSULTANTS, LLC
Entity type:Organization
Organization Name:ALAMO NUTRITION CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIJAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTLA
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD
Authorized Official - Phone:210-336-4437
Mailing Address - Street 1:621 CAMDEN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1612
Mailing Address - Country:US
Mailing Address - Phone:210-336-4437
Mailing Address - Fax:
Practice Address - Street 1:621 CAMDEN ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1612
Practice Address - Country:US
Practice Address - Phone:210-336-4437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81337133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty