Healthcare Provider Details

I. General information

NPI: 1699241075
Provider Name (Legal Business Name): ERIN CARROLL RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN GRIFFITH RD

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8140 WALNUT HILL LN STE 308
DALLAS TX
75231-4461
US

IV. Provider business mailing address

8140 WALNUT HILL LN STE 308
DALLAS TX
75231-4461
US

V. Phone/Fax

Practice location:
  • Phone: 214-348-5557
  • Fax: 214-348-5898
Mailing address:
  • Phone: 214-348-5557
  • Fax: 214-348-5898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT81429
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: