Provider Demographics
NPI:1093583551
Name:MONTES-CASAS, ROSA MARIA (MCN, RD, LD)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:MARIA
Last Name:MONTES-CASAS
Suffix:
Gender:F
Credentials:MCN, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 ROUTH CREEK PKWY APT 10208
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-0183
Mailing Address - Country:US
Mailing Address - Phone:915-261-6864
Mailing Address - Fax:
Practice Address - Street 1:2710 ROUTH CREEK PKWY APT 10208
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-0183
Practice Address - Country:US
Practice Address - Phone:915-261-6864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT89261133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered