Individual
KRISTEN ELIZABETH SHIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
411 PARK GROVE DR STE 720, KATY, TX 77450-1577
(713) 997-9613
Mailing address
3232 LAUREL BEND LN, PEARLAND, TX 77584-4569
(240) 291-8481
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86102056
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86102056
REGISTERED DIETITIAN
—
01
—
DT86882
LICENSED DIETITIAN
TX
Enumeration date
04/19/2021
Last updated
04/19/2021
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