Provider Demographics
NPI:1689092314
Name:OATZ, ELIZABETH-JANE (RD)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH-JANE
Middle Name:
Last Name:OATZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH-JANE
Other - Last Name:OATZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, CDE
Mailing Address - Street 1:2115 KRAMER LN STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4013
Mailing Address - Country:US
Mailing Address - Phone:512-978-9954
Mailing Address - Fax:
Practice Address - Street 1:1210 W BRAKER LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-3801
Practice Address - Country:US
Practice Address - Phone:512-978-9954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00986974133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered