Mary L Halliburton, RDN,CSR, LD

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

DT81903 Issued in TX

Practice address

4741 Joel Drive
Apt 33
El Paso, TX 79924

Phone

(915) 490-1718

Fax

(915) 307-8678

NPI assigned

Feb 6, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1366781676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 JOEL DR APT 33",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799246968",
            "telephone_number": "915-490-1718",
            "fax_number": "915-307-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 JOEL DRIVE",
            "address_2": "APT 33",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79924",
            "telephone_number": "915-490-1718",
            "fax_number": "915-307-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLIBURTON",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "RDN,CSR, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "TX",
            "license": "DT81903",
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "TX",
            "license": "DT81903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bishop Hall, FNP-C
• Dennise Hall
• Garrett Dennis Hall, BSN RN CSTR CAISS
• Kathryn Hall, DO
• Patricia Dolores Hall, MT(ASCP)
• Celina Hallman
• Kim Anita Halow, NURSE PRACTITIONER B
• Halsted Surgical Association
• Laith Hamdan
• Marah Hamdan

• Renal Nutrition Registered Dietitian in El Paso, TX
• Providers in El Paso, TX by specialty
• Renal Nutrition Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; 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.