Provider Demographics
NPI:1972616456
Name:CHASE, BRANDI
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17758 KATY FWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1335
Mailing Address - Country:US
Mailing Address - Phone:281-599-3039
Mailing Address - Fax:281-599-3024
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:713-794-7448
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX913078133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered