Provider Demographics
NPI:1760224968
Name:NOLTE FONG, JOY (PHD, MPH, RD)
Entity type:Individual
Prefix:DR
First Name:JOY
Middle Name:
Last Name:NOLTE FONG
Suffix:
Gender:F
Credentials:PHD, MPH, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 SUGARBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7252
Mailing Address - Country:US
Mailing Address - Phone:901-482-2665
Mailing Address - Fax:
Practice Address - Street 1:86 SUGARBERRY CIR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-7252
Practice Address - Country:US
Practice Address - Phone:901-482-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82967133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered