Active NPI
Kayla Broadhead, RD, LD, CNSC
- Registered Dietitian
- Houston, TX
National Provider Identifier
1467842880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT83032
- Practice address
- 6620 Main St
BCM 620
Houston, TX 77030-2348 - Phone
- (713) 798-4197
- NPI assigned
- Jan 24, 2015
- Last updated
- Jan 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT83032 | TX | Primary |
Addresses
Primary practice location
6620 Main St
BCM 620
Houston, TX 77030-2348
Mailing address
25612 Ayers LN
Porter, TX 77365-4698
Phone (713) 298-6821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422057600000",
"number": "1467842880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25612 AYERS LN",
"city": "PORTER",
"state": "TX",
"postal_code": "773654698",
"telephone_number": "713-298-6821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6620 MAIN ST",
"address_2": "BCM 620",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770302348",
"telephone_number": "713-798-4197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADHEAD",
"first_name": "KAYLA",
"credential": "RD, LD, CNSC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-24",
"last_updated": "2015-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT83032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
- Brli - Genpath Diagnostics, Inc (GenPath)
- Brli-Genpath Diagnostics, Inc
- Broad Health Texas International
- Kristen Broaddus, NP
- Lisa Bowen Broadfoot
- Stephanie Broadhurst, MSN, RN, IBCLC
- Broadstone Neurology Group LLC
- Broadway Dental & Braces PLLC
- Broadway Health Group LLC
- Broadway Medical Clinic, P.a.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.