Provider Demographics
NPI:1942489927
Name:PLYLER, CATHERINE VICTORIA (DIETITIAN)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:VICTORIA
Last Name:PLYLER
Suffix:
Gender:F
Credentials:DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9609 MARLBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-4653
Mailing Address - Country:US
Mailing Address - Phone:512-615-6873
Mailing Address - Fax:512-615-7123
Practice Address - Street 1:1611 HEADWAY CIR
Practice Address - Street 2:BUILDING 2
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5160
Practice Address - Country:US
Practice Address - Phone:512-613-6896
Practice Address - Fax:512-613-7123
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT05443133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered