Provider Demographics
NPI:1144960451
Name:NASCIMENTO COLSON, TAMIRIS (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:TAMIRIS
Middle Name:
Last Name:NASCIMENTO COLSON
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:TAMIRIS
Other - Middle Name:
Other - Last Name:DOS SANTOS NASCIMENTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RDN, LD
Mailing Address - Street 1:4707 WURZBACH RD APT 10303
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-2356
Mailing Address - Country:US
Mailing Address - Phone:210-852-5951
Mailing Address - Fax:
Practice Address - Street 1:4707 WURZBACH RD APT 10303
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-2356
Practice Address - Country:US
Practice Address - Phone:210-852-5951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86097766133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered