Provider Demographics
NPI:1174492227
Name:STONER, JAQUITA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:JAQUITA
Middle Name:
Last Name:STONER
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12712 W LAKE HOUSTON PKWY STE B-4148
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-6467
Mailing Address - Country:US
Mailing Address - Phone:409-932-4273
Mailing Address - Fax:
Practice Address - Street 1:12712 W LAKE HOUSTON PKWY STE B-4148
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-6467
Practice Address - Country:US
Practice Address - Phone:409-932-4273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88447133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered