Provider Demographics
NPI:1922185271
Name:MEIMERSTORF, ERIN MICHELLE (RD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MICHELLE
Last Name:MEIMERSTORF
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 1:5314 CARNABY ST
Mailing Address - Street 2:APT 145-10
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3110
Mailing Address - Country:US
Mailing Address - Phone:918-640-6673
Mailing Address - Fax:
Practice Address - Street 1:1935 MOTOR ST
Practice Address - Street 2:CLINICAL NUTRITION
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-2604
Practice Address - Fax:214-456-6287
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT80268133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
963201OtherREGISTERED DIETITIAN
TXDT80268OtherLICENSED DIETITIAN