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Organization

RENEGADE RD LLC

Active
Other names
The Renegade RD
Organization subpart
No

Provider details

NPI number
Authorized official
SANTIAGO CAPETILLO GUTIERREZ MS, RD, LD (REGISTERED DIETITIAN)
(936) 349-6546
Entity
Organization

Contact information

Practice address
909 BALSORA CV, GEORGETOWN, TX 78628-2637
(936) 349-6546
Mailing address
17350 STATE HIGHWAY 249 STE 220, HOUSTON, TX 77064-1132
(936) 349-6546

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
08/02/2024
Last updated
08/02/2024
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