Provider Demographics
NPI:1154734705
Name:ESTEP, MADELINE NICOLE (RD, LD)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:NICOLE
Last Name:ESTEP
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:
Other - Last Name:ESTEP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LD
Mailing Address - Street 1:1222 DUNSTON FALLS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3071
Mailing Address - Country:US
Mailing Address - Phone:318-218-4918
Mailing Address - Fax:
Practice Address - Street 1:700 N SAM HOUSTON PKWY W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77067-4338
Practice Address - Country:US
Practice Address - Phone:832-828-1593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82812133V00000X, 133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered