Provider Demographics
NPI:1407391741
Name:SCHAEFFER, JODI
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:SCHAEFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:PO BOX 160331
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-0331
Mailing Address - Country:US
Mailing Address - Phone:512-803-4558
Mailing Address - Fax:
Practice Address - Street 1:2100 PIPERS FIELD DR APT 24
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2547
Practice Address - Country:US
Practice Address - Phone:512-803-4558
Practice Address - Fax:512-803-4558
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84367133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered