Provider Demographics
NPI:1194050070
Name:CREMAR, LANCE (RD, LD)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:CREMAR
Suffix:
Gender:M
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 1:6551 STAR CT
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-9140
Mailing Address - Country:US
Mailing Address - Phone:956-523-7850
Mailing Address - Fax:956-523-7851
Practice Address - Street 1:6551 STAR CT
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-9140
Practice Address - Country:US
Practice Address - Phone:956-523-7850
Practice Address - Fax:956-523-7851
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05290133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered