Individual
MIRIAM GABRIELA LOPEZ NICOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
3724 JEFFERSON ST STE 104, AUSTIN, TX 78731-6204
(310) 598-8041
Mailing address
3724 JEFFERSON ST STE 104, AUSTIN, TX 78731-6204
(310) 598-8041
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86173570
CA
Other
Enumeration date
04/16/2026
Last updated
04/16/2026
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