OrganizationActive
Deer Lake Lodge, LLC
NPI 1922769231 · Nutritionist · Montgomery, TX
Deer Lake Lodge, LLC is a Nutritionist organization in Montgomery, TX (NPI 1922769231).
Provider details
- NPI number
- 1922769231
- Entity type
- Organization
- Primary specialty
- NutritionistDietary & Nutritional Service Providers
- Organization subpart
- No
- Authorized official
- Tracy Boulware, Spa & Wellness Director(281) 414-5111
Practice location
10500 Deer Lake Lodge Rd
Montgomery, TX 77316-9604
Phone: (281) 414-5111
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 70709
Houston, TX 77270-0709
Registry dates
- Enumerated
- 2022-01-08
- Last updated
- 2022-01-08
- Certified
- 2021-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.