Renegade Rd LLC
NPI #1467282673 in Georgetown, Texas
Provider Information
- NPI Number
- 1467282673
- Entity Type
- Organization
- Organization Name
- Renegade Rd LLC
- Primary Specialty
- Dietitian, Registered
- Enumeration Date
- Aug 2, 2024
- Last Updated
- Aug 2, 2024
Practice Location
- Address
- 909 BALSORA CV
- City
- Georgetown
- State
- Texas
- ZIP Code
- 78628-2637
- Phone
- (936) 349-6546
Authorized Official
- Name
- SANTIAGO CAPETILLO GUTIERREZ, MS, RD, LD
- Title
- REGISTERED DIETITIAN
- Phone
- (936) 349-6546
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dietitian, Registered |
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