Provider Demographics
NPI:1982801890
Name:VOLKERT, MARY ALICE (MS RD LD CDE)
Entity Type:Individual
Prefix:MRS
First Name:MARY ALICE
Middle Name:
Last Name:VOLKERT
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 1:4549 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4230
Mailing Address - Country:US
Mailing Address - Phone:713-669-9256
Mailing Address - Fax:713-669-9256
Practice Address - Street 1:6565 WEST LOOP SOUTH STE 510
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3504
Practice Address - Country:US
Practice Address - Phone:713-668-2759
Practice Address - Fax:713-668-2762
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT01669133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered