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Individual

MR. JONATHAN S SHANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNTP

Contact information

Practice address
3038 VILLAGE CREEK DR, KATY, TX 77494-6950
(832) 285-6739
Mailing address
3038 VILLAGE CREEK DR, KATY, TX 77494-6950
(832) 285-6739

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
5275
TX

Other

Enumeration date
11/05/2020
Last updated
11/05/2020
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