Provider Demographics
NPI:1932374196
Name:LENOX, TABITHA LOUISE (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:LOUISE
Last Name:LENOX
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:MISS
Other - First Name:TABITHA
Other - Middle Name:L
Other - Last Name:MAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:10101 FONDREN RD STE 331
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-5126
Mailing Address - Country:US
Mailing Address - Phone:844-532-7623
Mailing Address - Fax:832-532-4311
Practice Address - Street 1:10101 FONDREN RD STE 331
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5126
Practice Address - Country:US
Practice Address - Phone:844-532-7623
Practice Address - Fax:832-532-4311
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80655133V00000X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3717530-01Medicaid
TX3717530-02Medicaid