Provider Demographics
NPI:1689445926
Name:CHERUKOORU, HEMA (RD, LD)
Entity type:Individual
Prefix:MS
First Name:HEMA
Middle Name:
Last Name:CHERUKOORU
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 BAGDAD RD STE 404
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6519
Mailing Address - Country:US
Mailing Address - Phone:210-591-3640
Mailing Address - Fax:210-209-8250
Practice Address - Street 1:3624 ANDALUSIAN CT
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-4746
Practice Address - Country:US
Practice Address - Phone:512-422-4698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86292114133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered