Doctor Name: | SCOTT ALLEN BLACK |
NPI Number: | 1720284706 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RD |
License Number: | |
Business Practice Address: | 2200 Bergquist Dr Ste 1 Lackland A F B, TX - 782369908 |
Business Phone Number: | 2102926707 |
Business Fax Number: | |
Mailing Address: | 2200 Bergquist Drive, Suite 1, Attn Credentials Cmc, LACKLAND AFB |
State: | TX |
Postal Code: | 782365300 |
Phone Number: | 2102927964 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |