Tiffany Glenn, M.S., R.D., L.D.
Individual provider Active NPI Registered Dietitian · Lorena, TX
NPI 1740605641 · NPPES record last updated Feb 28, 2014
Key facts
- NPI
- 1740605641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DT03912 (TX)
- Practice address
- 500 Casa del Rancho Rd
Lorena, TX 76655-3179 - Phone
- (254) 716-0332
- NPI assigned
- Feb 28, 2014
- 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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT03912 | TX | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT03912 | TX | Yes |
Addresses
Primary practice location
500 Casa del Rancho Rd
Lorena, TX 76655-3179
Mailing address
500 Casa del Rancho Rd
Lorena, TX 76655-3179
Phone (254) 716-0332
Other providers in Lorena, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2014. 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.