Individual provider Active NPI

Diana Sofia Mireles Estrada, MS, RD, LD

  • Registered Dietitian
  • San Antonio, TX
National Provider Identifier
1073356200
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT89395 Issued in TX
Practice address
8002 Rolling Riv
San Antonio, TX 78249-3908
Phone
(210) 445-4015
NPI assigned
Jun 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT89395 TX Primary

Addresses

Primary practice location

8002 Rolling Riv
San Antonio, TX 78249-3908

Mailing address

8002 Rolling Riv
San Antonio, TX 78249-3908
Phone (210) 445-4015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DT89395TXMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1073356200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8002 ROLLING RIV",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493908",
            "telephone_number": "210-445-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8002 ROLLING RIV",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493908",
            "telephone_number": "210-445-4015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRELES ESTRADA",
        "first_name": "DIANA",
        "middle_name": "SOFIA",
        "credential": "MS, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT89395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.