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General NPI Number Information
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NPI Number | 1336267954
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Entity Type | Individual
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Provider Name | LEAH C MCDANIEL RD, LD, CDE
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5009 THOMPSON TER SUITE 101
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5850
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Country | US
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Telephone | 817-485-0384
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Fax | 817-485-0384
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Provider Business Mailing Address
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Address Line | 3609 CLIFFWOOD DR
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City | COLLEYVILLE
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State | TX
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Zip | 76034-8652
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Country | US
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Telephone | 817-485-0384
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Fax | 817-485-0384
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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 | 00822
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License Number State | TX
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