Provider Demographics
NPI:1023625787
Name:ROBBEN, SAMANTHA CLAIRE (RDN)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:CLAIRE
Last Name:ROBBEN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 MAYFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-3111
Mailing Address - Country:US
Mailing Address - Phone:214-277-4167
Mailing Address - Fax:
Practice Address - Street 1:10300 N CENTRAL EXPY STE 280
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-8666
Practice Address - Country:US
Practice Address - Phone:469-215-2931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered