Provider Demographics
NPI:1285751347
Name:JUAREZ, VERONICA A (RD)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:A
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:A
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:2727 W HOLCOMBE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1669
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:2727 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1669
Practice Address - Country:US
Practice Address - Phone:713-442-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT06199133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A2141Medicare ID - Type Unspecified
TX8A2140Medicare ID - Type Unspecified
TX8A2143Medicare ID - Type Unspecified
TXP75217Medicare UPIN
TX8A2142Medicare ID - Type Unspecified