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General NPI Number Information
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NPI Number | 1588438758
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Entity Type | Individual
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Provider Name | JACQUELINE GUADALUPE ACOSTA RD, LD
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Gender | Female
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 1001 RONE DR
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City | WESLACO
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State | TX
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Zip | 78596-4843
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Country | US
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Telephone | 956-600-3475
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Fax |
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Provider Business Mailing Address
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Address Line | 2833 GLYNWOOD DR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4418
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Country | US
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Telephone | 956-443-5289
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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 | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT89122
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License Number State | TX
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