Trista E Prasifka, R.D., L.D.
Individual provider Active NPI Registered Dietitian · Ovilla, TX
NPI 1003168501 · NPPES record last updated Oct 8, 2012
Key facts
- NPI
- 1003168501
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DT81511 (TX)
- Practice address
- 119 Meadow Glen LN
Ovilla, TX 75154-1665 - Phone
- (214) 597-1248
- NPI assigned
- Oct 8, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT81511 | TX | Yes |
Addresses
Primary practice location
119 Meadow Glen LN
Ovilla, TX 75154-1665
Mailing address
119 Meadow Glen LN
Ovilla, TX 75154-1665
Phone (214) 597-1248
Other providers in Ovilla, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.