Provider Demographics
NPI:1497931216
Name:MOJICA, CAMELA J (RD, LD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:CAMELA
Middle Name:J
Last Name:MOJICA
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11812 PALISADES PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1241
Mailing Address - Country:US
Mailing Address - Phone:214-293-9354
Mailing Address - Fax:
Practice Address - Street 1:11812 PALISADES PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1241
Practice Address - Country:US
Practice Address - Phone:214-293-9354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07313133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K3966Medicare PIN
TX8K3967Medicare PIN
TX8K3965Medicare PIN