Provider Demographics
NPI:1457162661
Name:TROYER, MADISON (MPH, RDN)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:TROYER
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 VILLAGE BEND DR APT 206
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-3735
Mailing Address - Country:US
Mailing Address - Phone:919-717-3381
Mailing Address - Fax:
Practice Address - Street 1:6060 VILLAGE BEND DR APT 206
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-3735
Practice Address - Country:US
Practice Address - Phone:919-717-3381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87868133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered