Stephanie Alyce Olivares, D.T.R. , M.S.

Primary specialty

Registered Dietetic TechnicianTaxonomy code 136A00000X

Practice address

14330 Midway Rd
Ste 121
Dallas, TX 75244-3522

Phone

(972) 930-0260

NPI assigned

Apr 4, 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

Other names 1

• Stephanie Alyce Behrendt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Living Well Dallas, Inc.

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1902951221

  Nutritionist

  NPD (past)

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1528301959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14330 MIDWAY RD",
            "address_2": "STE 121",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443522",
            "telephone_number": "972-930-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14330 MIDWAY RD",
            "address_2": "STE 121",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443522",
            "telephone_number": "972-930-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "STEPHANIE",
        "middle_name": "ALYCE",
        "credential": "D.T.R.  , M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "BEHRENDT",
            "middle_name": "ALYCE",
            "credential": "D.T.R., M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrea Alexis Oliphant, ATP
• Ashley Oliphant, LMSW
• Crystal Oliva, LVN
• Juan Carlos Oliva, PHARMD
• Dawn Olivares, OTR
• Marcia Jill Oliveira, M.D.
• Oliver Street 5.01(a) Inc.
• Kendria Monique Oliver-Hudson, CNM
• Ashley Oliver, QMHP
• Cheryl Oliver, P.T.

• Registered Dietetic Technician in Dallas, TX
• Providers in Dallas, TX by specialty
• Registered Dietetic Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.