MEDICARE: BRITTNEY CROSS RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1487293957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY CROSS RD

Provider Business Mailing Address
First Line	:	1601 ELM ST STE 4360
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-4701
Country	:	US
Telephone Number	:	844-473-2455
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 ELM ST STE 4360
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-4701
Country	:	US
Telephone Number	:	844-473-2455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2020
Last Update Date	:	01/02/2020

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Directions to “ BRITTNEY CROSS RD” Practice Location

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