Provider Demographics
NPI:1679446462
Name:SMITH, SARAH CATHERINE (MS RD,LD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CATHERINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS RD,LD
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:C
Other - Last Name:GRENTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS RD, LD
Mailing Address - Street 1:422 SALT CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-2239
Mailing Address - Country:US
Mailing Address - Phone:972-697-9445
Mailing Address - Fax:
Practice Address - Street 1:422 SALT CEDAR DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-2239
Practice Address - Country:US
Practice Address - Phone:972-697-9445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT04933133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered