Provider Demographics
NPI:1073392205
Name:PLAISANCE, MARGARET PEYTON (RDN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:PEYTON
Last Name:PLAISANCE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11325 PARK VISTA BLVD APT 2323
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-7169
Mailing Address - Country:US
Mailing Address - Phone:817-897-8050
Mailing Address - Fax:
Practice Address - Street 1:11325 PARK VISTA BLVD APT 2323
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-7169
Practice Address - Country:US
Practice Address - Phone:817-897-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX086210563133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered