Individual
TAMRA LEI BOTELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4440 E HIGHWAY 287, MIDLOTHIAN, TX 76065-5576
(972) 723-5590
Mailing address
4440 E HIGHWAY 287, MIDLOTHIAN, TX 76065-5576
(972) 723-5590
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT81661
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
09/11/2012
Last updated
04/07/2014
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