Individual
KRISTEN TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CNSC
Contact information
Practice address
15 VENETO LN, MISSOURI CITY, TX 77459-1166
(281) 995-1323
Mailing address
15 VENETO LN, MISSOURI CITY, TX 77459-1166
(281) 995-1323
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT80388
TX
Other
Enumeration date
01/06/2019
Last updated
01/06/2019
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