Provider Demographics
NPI:1184038317
Name:CHAUDHARI, SHELLY SMITH (RD, LD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:SMITH
Last Name:CHAUDHARI
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 6TH AVE S
Mailing Address - Street 2:4TH FLOOR ENDOCRINOLOGY
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-2110
Mailing Address - Country:US
Mailing Address - Phone:205-996-7774
Mailing Address - Fax:205-975-6583
Practice Address - Street 1:900 W MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-8517
Practice Address - Country:US
Practice Address - Phone:054-016-6782
Practice Address - Fax:205-975-6583
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2014133V00000X
TXDT83629133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered