Provider Demographics
NPI:1407034093
Name:AJMERA, SHEFALI R (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:SHEFALI
Middle Name:R
Last Name:AJMERA
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13706 RESEARCH BLVD
Mailing Address - Street 2:SUITE 211G
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1882
Mailing Address - Country:US
Mailing Address - Phone:512-998-5255
Mailing Address - Fax:888-668-6889
Practice Address - Street 1:13706 RESEARCH BLVD
Practice Address - Street 2:SUITE 211G
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1882
Practice Address - Country:US
Practice Address - Phone:512-998-5255
Practice Address - Fax:888-668-6889
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80407133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered