Fahimah Yazdanfard Callahan, RD
Individual provider Active NPI Registered Dietitian · Lytle, TX
NPI 1710145958 · NPPES record last updated May 10, 2011
Key facts
- NPI
- 1710145958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DT 80799 (TX)
- Practice address
- 14832 Main St.
Usrenal Caretri-County Dialysis
Lytle, TX 78052 - Phone
- (830) 772-5784
- Fax
- (830) 772-5793
- NPI assigned
- May 23, 2008
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT 80799 | TX | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT 80799 | TX | Yes |
Addresses
Primary practice location
14832 Main St.
Usrenal Caretri-County Dialysis
Lytle, TX 78052
Mailing address
14 Knights Peak
San Antonio, TX 78254-2511
Phone (210) 872-6105
Other providers in Lytle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2011. 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.