Provider Demographics
NPI:1023732138
Name:ISCIMENLER, EROL SELAHATTIN (RDN, LD)
Entity type:Individual
Prefix:MR
First Name:EROL
Middle Name:SELAHATTIN
Last Name:ISCIMENLER
Suffix:
Gender:M
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 KIMBERLY RD
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2090
Mailing Address - Country:US
Mailing Address - Phone:580-579-1469
Mailing Address - Fax:
Practice Address - Street 1:500 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7354
Practice Address - Country:US
Practice Address - Phone:903-870-2195
Practice Address - Fax:903-870-4639
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83707133V00000X
OK770133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered