Organization
FUNCTIONAL RD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AIMEE ELIZABETH SENIOR RD, LD (REGISTERED DIETITIAN)
(210) 920-0669
Entity
Organization
Contact information
Practice address
11107 WURZBACH RD, SAN ANTONIO, TX 78230-2500
(210) 920-0669
(210) 920-6645
Mailing address
14439 NW MILITARY HWY STE 108, SHAVANO PARK, TX 78231-1648
(210) 920-0669
(210) 920-6645
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
133V00000X
Registered Dietitian
Primary
DT83404
TX
Other
Enumeration date
09/06/2017
Last updated
01/20/2026
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