Provider Demographics
NPI:1780152181
Name:EL DADA, AMANI (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:AMANI
Middle Name:
Last Name:EL DADA
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 1:888 S GREENVILLE AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5044
Mailing Address - Country:US
Mailing Address - Phone:214-216-2809
Mailing Address - Fax:945-468-7340
Practice Address - Street 1:888 S GREENVILLE AVE STE 304
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5044
Practice Address - Country:US
Practice Address - Phone:214-216-2809
Practice Address - Fax:945-468-7340
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84679133V00000X
TX133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered