Provider Demographics
NPI:1124648191
Name:RENEW NUTRITION SOLUTIONS
Entity type:Organization
Organization Name:RENEW NUTRITION SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:979-492-8357
Mailing Address - Street 1:6160 WARREN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9415
Mailing Address - Country:US
Mailing Address - Phone:979-492-8357
Mailing Address - Fax:
Practice Address - Street 1:6160 WARREN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9415
Practice Address - Country:US
Practice Address - Phone:979-492-8357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty