Provider Demographics
NPI:1457174666
Name:CAVIL, DONNA TATMAN (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:TATMAN
Last Name:CAVIL
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:TATMAN
Other - Last Name:CAVIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:10003 CHARIOT TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5921
Mailing Address - Country:US
Mailing Address - Phone:210-441-1612
Mailing Address - Fax:
Practice Address - Street 1:10003 CHARIOT TRL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-5921
Practice Address - Country:US
Practice Address - Phone:210-441-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81310133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered