Provider Demographics
NPI:1780129916
Name:NAUGHTON, ANDREA (MPH, RD, LD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:MPH, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10970 SHADOW CREEK PKWY
Mailing Address - Street 2:#270
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0100
Mailing Address - Country:US
Mailing Address - Phone:713-840-5210
Mailing Address - Fax:
Practice Address - Street 1:10970 SHADOW CREEK PKWY
Practice Address - Street 2:#270
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-0100
Practice Address - Country:US
Practice Address - Phone:713-840-5210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-25
Last Update Date:2016-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84125133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered