Provider Demographics
NPI:1568740496
Name:CABRAL, MARY E (RD/LD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:CABRAL
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CITRINE CV
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2272
Mailing Address - Country:US
Mailing Address - Phone:972-880-8443
Mailing Address - Fax:
Practice Address - Street 1:1011 CITRINE CV
Practice Address - Street 2:
Practice Address - City:OAK POINT
Practice Address - State:TX
Practice Address - Zip Code:75068-2272
Practice Address - Country:US
Practice Address - Phone:972-880-8443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT04217133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered