Provider Demographics
NPI:1720401623
Name:MICHALSKY, LINDA O (RD, LD, PHD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:O
Last Name:MICHALSKY
Suffix:
Gender:F
Credentials:RD, LD, PHD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:R
Other - Last Name:OLDFATHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9052
Mailing Address - Country:US
Mailing Address - Phone:214-648-3045
Mailing Address - Fax:214-648-1514
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9052
Practice Address - Country:US
Practice Address - Phone:214-648-3045
Practice Address - Fax:214-648-1514
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80828133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered