MEDICARE: MRS. TERESA JARAMILLO RD,LD

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	DT80776	TX

General Provider Information

NPI Number	:	1538395934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERESA JARAMILLO RD,LD

Provider Business Mailing Address
First Line	:	11616 CASA VIEW DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-6509
Country	:	US
Telephone Number	:	254-289-0760
Fax Number	:

Provider Business Practice Location Address
First Line	:	11616 CASA VIEW DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-6509
Country	:	US
Telephone Number	:	254-289-0760
Fax Number	:

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

Provider Enumeration Date	:	05/31/2009
Last Update Date	:	05/19/2026

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