Provider Demographics
NPI:1912140146
Name:GARRIGA, JAMILLE EDNEE (DIETITIAN)
Entity Type:Individual
Prefix:
First Name:JAMILLE
Middle Name:EDNEE
Last Name:GARRIGA
Suffix:
Gender:F
Credentials:DIETITIAN
Other - Prefix:
Other - First Name:JAMILLE
Other - Middle Name:
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DIETITIAN
Mailing Address - Street 1:938 POYDRAS ST
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-6355
Mailing Address - Country:US
Mailing Address - Phone:281-808-5339
Mailing Address - Fax:
Practice Address - Street 1:938 POYDRAS ST
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-6355
Practice Address - Country:US
Practice Address - Phone:281-808-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT03855133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT03855OtherTEXAS DIETITIAN LICENSURE NUMBER