Provider Demographics
NPI:1750194254
Name:ROTONDI, ELIZABETH THERESE (RD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:THERESE
Last Name:ROTONDI
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 1:2929 OAK LAWN AVE APT 446
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5806
Mailing Address - Country:US
Mailing Address - Phone:704-488-8514
Mailing Address - Fax:
Practice Address - Street 1:2929 OAK LAWN AVE APT 446
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5806
Practice Address - Country:US
Practice Address - Phone:704-488-8514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT90487133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered