Provider Demographics
NPI:1548746290
Name:FAYAD, SAHAR (RD, LD, CDCES)
Entity Type:Individual
Prefix:
First Name:SAHAR
Middle Name:
Last Name:FAYAD
Suffix:
Gender:F
Credentials:RD, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 GREENS PRAIRIE RD W STE 101A
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8666
Mailing Address - Country:US
Mailing Address - Phone:979-465-7618
Mailing Address - Fax:
Practice Address - Street 1:1551 GREENS PRAIRIE RD W STE 101A
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8666
Practice Address - Country:US
Practice Address - Phone:979-465-7618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV39393-DI-0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered