MEDICARE: KELSIE KROPP RD

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
1	133V00000X	Registered Dietitian	DT92072	TX

General Provider Information

NPI Number	:	1861295131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSIE KROPP RD

Provider Business Mailing Address
First Line	:	422 W RIVERSIDE DR APT 207
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-1590
Country	:	US
Telephone Number	:	832-444-0783
Fax Number	:	832-444-0783

Provider Business Practice Location Address
First Line	:	422 W RIVERSIDE DR APT 207
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-1590
Country	:	US
Telephone Number	:	832-444-0783
Fax Number	:	832-444-0783

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	03/31/2025

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Directions to “ KELSIE KROPP RD” Practice Location

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