Provider Demographics
NPI:1154975233
Name:BROWN, KRISTINA (RD, LD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22834 RIVER BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5421
Mailing Address - Country:US
Mailing Address - Phone:281-630-5717
Mailing Address - Fax:
Practice Address - Street 1:22834 RIVER BIRCH DR
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5421
Practice Address - Country:US
Practice Address - Phone:281-630-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-28
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85919133N00000X
TX86091515133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist