Provider Demographics
NPI:1750517223
Name:HOLBEN, AMANDA JEAN (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JEAN
Last Name:HOLBEN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:JEAN
Other - Last Name:BULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:3226 SENECA LANDING LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1924
Mailing Address - Country:US
Mailing Address - Phone:713-588-0544
Mailing Address - Fax:
Practice Address - Street 1:2323 S SHEPHERD DR
Practice Address - Street 2:STE 1012
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-7019
Practice Address - Country:US
Practice Address - Phone:713-588-0544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81026133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered