Individual
KAYLA BROADHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CNSC
Contact information
Practice address
6620 MAIN ST, BCM 620, HOUSTON, TX 77030-2348
(713) 798-4197
Mailing address
25612 AYERS LN, PORTER, TX 77365-4698
(713) 298-6821
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT83032
TX
Other
Enumeration date
01/24/2015
Last updated
01/24/2015
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