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Organization
VITAL NUTRITION 12 LLC
Active
Organization
VITAL NUTRITION 12 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAHAR FAYAD RD, LD, CDCES (OWNER)
(979) 465-7618
Entity
Organization
Contact information
Practice address
1551 GREENS PRAIRIE RD W STE 101A, COLLEGE STATION, TX 77845-8666
(818) 726-3495
Mailing address
1551 GREENS PRAIRIE RD W STE 101A, COLLEGE STATION, TX 77845-8666
(979) 465-7618
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/04/2022
Last updated
09/24/2022
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