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NPI Code Detail

MEDICARE: HALEY LAURA PFANNSTIEL RDN

MEDICARE: HALEY LAURA PFANNSTIEL RDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDT86136TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326694035
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY LAURA PFANNSTIEL RDN
Provider Business Mailing Address
First Line : 700 E PARK BLVD STE 206
Second Line :
City : PLANO
State : TX
Zip : 75074-5472
Country : US
Telephone Number : 972-422-9180
Fax Number :
Provider Business Practice Location Address
First Line : 700 E PARK BLVD STE 206
Second Line :
City : PLANO
State : TX
Zip : 75074-5472
Country : US
Telephone Number : 972-422-9180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2019
Last Update Date : 12/29/2021

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Directions to “ HALEY LAURA PFANNSTIEL RDN” Practice Location

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