Provider Demographics
NPI:1235287426
Name:GAITONDE, VIDYA (MS, RD, LD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:VIDYA
Middle Name:
Last Name:GAITONDE
Suffix:
Gender:F
Credentials:MS, 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 1:101 JOLLEY ST
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4815
Mailing Address - Country:US
Mailing Address - Phone:830-591-3938
Mailing Address - Fax:
Practice Address - Street 1:101 JOLLEY ST
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-4815
Practice Address - Country:US
Practice Address - Phone:830-591-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT00954133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered