Provider Demographics
NPI:1841788379
Name:DELCOURE, LESA (MS, RD, LD, CDE)
Entity type:Individual
Prefix:
First Name:LESA
Middle Name:
Last Name:DELCOURE
Suffix:
Gender:F
Credentials:MS, RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20010 CAPE CLOVER TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4087
Mailing Address - Country:US
Mailing Address - Phone:281-740-9864
Mailing Address - Fax:
Practice Address - Street 1:23900 KATY FWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1323
Practice Address - Country:US
Practice Address - Phone:281-740-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX865267133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered