Provider Demographics
NPI:1770256976
Name:NEEDLES, PAIGE (RD)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:NEEDLES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 DESCO DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-1602
Mailing Address - Country:US
Mailing Address - Phone:713-249-0418
Mailing Address - Fax:
Practice Address - Street 1:5809 DESCO DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-1602
Practice Address - Country:US
Practice Address - Phone:713-249-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86156997133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered