Provider Demographics
NPI:1619760105
Name:MURBACH, TIFFANY ROSE (RD)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ROSE
Last Name:MURBACH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 SANTA RITA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-1061
Mailing Address - Country:US
Mailing Address - Phone:832-243-2736
Mailing Address - Fax:
Practice Address - Street 1:6615 SANTA RITA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-1061
Practice Address - Country:US
Practice Address - Phone:832-243-2736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT92183133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered