Provider Demographics
NPI:1649078015
Name:BARDELOZA, CHRISTABELLE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:CHRISTABELLE
Middle Name:
Last Name:BARDELOZA
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 WAYNOKA DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2793
Mailing Address - Country:US
Mailing Address - Phone:214-601-7057
Mailing Address - Fax:
Practice Address - Street 1:3613 WAYNOKA DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2793
Practice Address - Country:US
Practice Address - Phone:214-601-7057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86969133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered