Provider Demographics
NPI:1710039730
Name:LARROCA, JANET (RD,LD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:LARROCA
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:PO BOX 828
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8144
Mailing Address - Country:US
Mailing Address - Phone:972-359-1110
Mailing Address - Fax:
Practice Address - Street 1:1416 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1806
Practice Address - Country:US
Practice Address - Phone:972-359-1110
Practice Address - Fax:972-359-1119
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT01554133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTPI 1405516-01Medicaid