| Ms Cynthia K Green, ED DIETITIAN | |
|
1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 | |
| (830) 672-7581 | |
| (830) 672-2401 |
| Full Name | Ms Cynthia K Green |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 1110 N Sarah Dewitt Dr, Gonzales, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568565497 | NPI | - | NPPES |
| 3460982 | Medicaid | TX | |
| 00L70B | Other | TX | MEDICARE GROUP NUMBER |
| 862948 | Other | TX | DIETETIC REGISTRATION |
| DT05451 | Other | TX | LICENSED DIETITIAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 862948 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Cynthia K Green, ED DIETITIAN 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 Ph: (830) 672-7581 | Ms Cynthia K Green, ED DIETITIAN 1110 N Sarah Dewitt Dr, Gonzales, TX 78629-3311 Ph: (830) 672-7581 |
Kristen Wollmuth, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1110 N Sarah Dewitt Dr, Gonzales, TX 78629 Phone: 830-672-7581 Fax: 830-672-2401 |