Provider Demographics
NPI:1447758412
Name:GEORGE, KAYLEY ELIZABETH (RD)
Entity Type:Individual
Prefix:
First Name:KAYLEY
Middle Name:ELIZABETH
Last Name:GEORGE
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 1:9222 TURTLE POND LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6970
Mailing Address - Country:US
Mailing Address - Phone:281-299-2844
Mailing Address - Fax:
Practice Address - Street 1:6430 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9638
Practice Address - Country:US
Practice Address - Phone:855-481-1149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-24
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85148133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered