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Contact Information

TAMRA L BOTELER
4440 E HIGHWAY 287
MIDLOTHIAN, TX76065-5576
 Phone: 972-723-5590
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Pediatric

133VN1004X 71 Registered Dietitian or Nutrition Professional
 

Nutrition, Education

133NN1002X
Indicates primary specialty

NPI Profile & details for TAMRA L BOTELER · (Female)

NPI # 1194075762
Status Active
Credentials
Entity Individual
Enumeration date 09/11/2012
Last updated 04/07/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • TX License # DT81661
  • TX Medicaid 149984001
  • TX Medicaid 207164901
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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