Individual
AMBER GRAPEVINE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
1303 MCCULLOUGH AVE, SUITE GL 70, SAN ANTONIO, TX 78212-5609
(210) 226-9705
(210) 223-4555
Mailing address
367 E RAMSEY RD, SAN ANTONIO, TX 78216-4636
(210) 349-9300
(210) 366-2558
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT06583
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT06583
LICENSE NUMBER
TX
Enumeration date
11/16/2005
Last updated
07/08/2007
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