Provider Demographics
NPI:1487412524
Name:OLVERA, DULCE MONIQUE (RD, LD)
Entity type:Individual
Prefix:
First Name:DULCE
Middle Name:MONIQUE
Last Name:OLVERA
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 1:2180 NORTH LOOP W STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8014
Mailing Address - Country:US
Mailing Address - Phone:650-770-9243
Mailing Address - Fax:833-895-1988
Practice Address - Street 1:2180 NORTH LOOP W STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8014
Practice Address - Country:US
Practice Address - Phone:650-770-9243
Practice Address - Fax:833-895-1988
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87999133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty