Individual provider · NPI-1
Emerson Barros Venceslau
Nutritionist · Conroe, TX
NPI number1265247654
StatusActive
Last updated in NPPESMar 4, 2025
Details
- NPI
- 1265247654
- Entity type
- Individual (NPI-1)
- Name
- Emerson Barros Venceslau
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 11, 2025
- Certification date
- Mar 4, 2025
- Last updated
- Mar 4, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133N00000X | Nutritionist | – | – | Yes |
| 133NN1002X | Nutritionist, Nutrition, Education | – | – |
Practice location
15914 Imperial Pine CtConroe, TX 77302-2319
Phone 832-226-2718
Mailing address
15914 Imperial Pine CtConroe, TX 77302-2319
Phone 832-226-2718
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