Provider Demographics
NPI:1205272424
Name:ROTHSCHILD, MEAGAN (RD)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:ROTHSCHILD
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 1:2525 N HENDERSON AVE
Mailing Address - Street 2:#234
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6688
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2525 N HENDERSON AVE
Practice Address - Street 2:#234
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-6688
Practice Address - Country:US
Practice Address - Phone:817-832-4599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82168133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered