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General NPI Number Information
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NPI Number | 1285851394
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Entity Type | Individual
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Provider Name | KATHY ADAMS GLENN MS RD LD
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1353 N WESTMORELAND RD BUILDING F
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City | DALLAS
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State | TX
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Zip | 75211-1655
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Country | US
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Telephone | 214-331-0108
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Fax | 214-333-7097
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Provider Business Mailing Address
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Address Line | 6410 LAKESHORE DR
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City | DALLAS
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State | TX
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Zip | 75214-3737
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Country | US
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Telephone | 214-802-2574
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT01542
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License Number State | TX
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