Provider Demographics
NPI:1700399003
Name:WANGSGAARD, MARGARET F (RDN, LD)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:F
Last Name:WANGSGAARD
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:MRS
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:WANGSGAARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN, LD
Mailing Address - Street 1:3262 DOTHAN LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-3840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3262 DOTHAN LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229
Practice Address - Country:US
Practice Address - Phone:615-351-4071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83963133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered