Provider Demographics
NPI:1912565797
Name:SAFIR, MELINDA (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:SAFIR
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6931 ROBIN WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-2915
Mailing Address - Country:US
Mailing Address - Phone:214-280-4868
Mailing Address - Fax:
Practice Address - Street 1:5941 DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-9001
Practice Address - Country:US
Practice Address - Phone:972-758-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05605133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered