Provider Demographics
NPI:1801687629
Name:LAZARUS, SHARON RACHEL (RD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:RACHEL
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 WHITE PINE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3447
Mailing Address - Country:US
Mailing Address - Phone:210-232-0455
Mailing Address - Fax:
Practice Address - Street 1:2245 TEXAS DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1679
Practice Address - Country:US
Practice Address - Phone:832-537-0822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT92181133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered