Provider Demographics
NPI:1013016633
Name:CARRILLO, MARIA-PAULA (MS, RDN, LD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA-PAULA
Middle Name:
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 REPUBLIC DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5481
Mailing Address - Country:US
Mailing Address - Phone:972-422-9180
Mailing Address - Fax:
Practice Address - Street 1:555 REPUBLIC DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5481
Practice Address - Country:US
Practice Address - Phone:972-422-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07335133VN1004X
9717533133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric