Organization
DIABETES AMERICA, LLC
Active
Parent organization
DCOA-PA, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
DCOA-PA, PA
Authorized official
NAKEVA TILLEY (DIRECTOR OF OPERATIONS)
(713) 840-5153
Entity
Organization
Contact information
Practice address
13100 NORTHWEST FWY, HOUSTON, TX 77040-6310
(832) 237-3500
(281) 897-9906
Mailing address
4011 AVENUE S 1/2, GALVESTON, TX 77550-8637
(409) 795-1344
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
DT80784
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT80784
LD
TX
Enumeration date
12/14/2015
Last updated
12/14/2015
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