Provider Demographics
NPI:1083209522
Name:CAVALIER, ANNIE (RDN)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:CAVALIER
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 1:418 W LOUISIANA ST
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4444
Mailing Address - Country:US
Mailing Address - Phone:214-240-2773
Mailing Address - Fax:
Practice Address - Street 1:418 W LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-4444
Practice Address - Country:US
Practice Address - Phone:214-240-2773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86153298133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered