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General NPI Number Information
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NPI Number | 1457736183
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Entity Type | Individual
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Provider Name | ALLISON BLAIR REZENTES MS, RD/LD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 07/23/2015
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Provider Practice Location Address
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Address Line | 5204 COLLEYVILLE BLVD
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5829
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Country | US
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Telephone | 817-581-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 1735 CIRCLE CREEK DR
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City | LEWISVILLE
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State | TX
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Zip | 75067-4961
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Country | US
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Telephone | 940-595-6154
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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 | DT82976
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License Number State | TX
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