Provider Demographics
NPI:1417481169
Name:ABREU, JOYCE GUILHERMINO (RD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:GUILHERMINO
Last Name:ABREU
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5107 VICKERY BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6224
Mailing Address - Country:US
Mailing Address - Phone:508-617-9522
Mailing Address - Fax:
Practice Address - Street 1:5107 VICKERY BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-6224
Practice Address - Country:US
Practice Address - Phone:508-617-9522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84745133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered