Individual
MS. ANDREA CHACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D, CLE
Contact information
Practice address
4817 DIAZ AVE, FORT WORTH, TX 76107-6131
(682) 465-9531
Mailing address
4817 DIAZ AVE, FORT WORTH, TX 76107-6131
(682) 465-9531
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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