Provider Demographics
NPI:1306800990
Name:ZBOJNIEWICZ, LEE JOHN (RD, LD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:JOHN
Last Name:ZBOJNIEWICZ
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 1:27003 RUSTIC STAR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20330 HUEBNER RD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3509
Practice Address - Country:US
Practice Address - Phone:210-491-9655
Practice Address - Fax:210-491-9689
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07373133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered