Provider Demographics
NPI:1700127685
Name:GIVENS, ERICA CARYN (RD)
Entity Type:Individual
Prefix:MISS
First Name:ERICA
Middle Name:CARYN
Last Name:GIVENS
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 1:401 CROOKED CRK
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-3146
Mailing Address - Country:US
Mailing Address - Phone:281-794-7291
Mailing Address - Fax:
Practice Address - Street 1:401 CROOKED CRK
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-3146
Practice Address - Country:US
Practice Address - Phone:281-794-7291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82607133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered