Individual
MS. MYRIAN JEANETTE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, CDE
Contact information
Practice address
1200 BROOKLYN AVENUE, SUITE 240, SAN ANTONIO, TX 78212-4830
(210) 225-4511
(210) 225-4514
Mailing address
7834 BROADWAY ST, #601, SAN ANTONIO, TX 78209-2568
(210) 372-2997
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT07511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011-0463
CERTIFIED DIABETES EDUCATOR
TX
01
—
961737
REGISTERED DIETITIAN
TX
Enumeration date
07/23/2010
Last updated
11/17/2010
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