Provider Demographics
NPI:1336979079
Name:GRANZIN, KIRBEY (RD)
Entity type:Individual
Prefix:MRS
First Name:KIRBEY
Middle Name:
Last Name:GRANZIN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:KIRBEY
Other - Middle Name:
Other - Last Name:KRAWCZYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1666 MCQUEENEY RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4809
Mailing Address - Country:US
Mailing Address - Phone:830-237-9709
Mailing Address - Fax:
Practice Address - Street 1:1666 MCQUEENEY RD
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4809
Practice Address - Country:US
Practice Address - Phone:830-237-9709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83917133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered