Active NPI
Paola Isabella Vivar Andrade, RD LD
- Registered Dietitian
- Fort Worth, TX
National Provider Identifier
1508641861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT89275
- Practice address
- 1500 Cooper St
Fort Worth, TX 76104-2710 - Phone
- (682) 885-6299
- Fax
- (682) 885-1090
- NPI assigned
- Aug 25, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | |||
| Registered Dietitian | 133V00000X | DT89275 | TX | Primary |
Addresses
Primary practice location
1500 Cooper St
Fort Worth, TX 76104-2710
Mailing address
PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741132800000",
"number": "1508641861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 733784",
"city": "DALLAS",
"state": "TX",
"postal_code": "753733784",
"telephone_number": "682-885-6483",
"fax_number": "682-885-3113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 COOPER ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042710",
"telephone_number": "682-885-6299",
"fax_number": "682-885-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIVAR ANDRADE",
"first_name": "PAOLA",
"middle_name": "ISABELLA",
"credential": "RD LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-25",
"last_updated": "2025-03-05",
"certification_date": "2025-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT89275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
- Vitality Clinical Services PLLC
- Vitas Healthcare of Texas, L. P.
- Vitas Healthcare of Texas, L.P.
- Patricia Vitiello, CD, CPD, CBC, CBE
- Rodney D Vitovsky, PA-C
- Jennifer D Vivas
- Vivicare Health Partners, LLC (Team Select Home Care)
- Vivid Dentistry PLLC (Vosh Dental)
- Saranya Viyapon, DMD
- Angela Vizcaino, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.