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NPI Code Detail

MEDICARE: MARY E CABRAL RD/LD

MEDICARE: MARY E CABRAL RD/LD
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 DietitianDT04217TX

General Provider Information

NPI Number : 1568740496
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E CABRAL RD/LD
Provider Business Mailing Address
First Line : 1011 CITRINE CV
Second Line :
City : OAK POINT
State : TX
Zip : 75068-2272
Country : US
Telephone Number : 972-880-8443
Fax Number :
Provider Business Practice Location Address
First Line : 1011 CITRINE CV
Second Line :
City : OAK POINT
State : TX
Zip : 75068-2272
Country : US
Telephone Number : 972-880-8443
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2011
Last Update Date : 01/19/2015

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Directions to “ MARY E CABRAL RD/LD” Practice Location

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