Provider Demographics
NPI:1447617329
Name:DAVIS, JANEL (RD, LD)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:JANEL
Other - Middle Name:LORAINE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15508 BELFIN DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-3853
Mailing Address - Country:US
Mailing Address - Phone:512-417-2027
Mailing Address - Fax:
Practice Address - Street 1:15508 BELFIN DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-3853
Practice Address - Country:US
Practice Address - Phone:512-417-2027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80240133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered