Provider Demographics
NPI:1881630812
Name:MCALISTER, MICHELE (MS,RD,LD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:MCALISTER
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 BOAT HOUSE BLVD UNIT 305
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4492
Mailing Address - Country:US
Mailing Address - Phone:325-829-2606
Mailing Address - Fax:855-811-9597
Practice Address - Street 1:1541 N 4TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5648
Practice Address - Country:US
Practice Address - Phone:325-829-2606
Practice Address - Fax:855-811-9597
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX726707133V00000X
TXDT03673133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered