STEPHANIE NICOLE SOUTHALL (NPI# 1932390275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932390275 |
| Entity Type | Individual |
| Full Name | STEPHANIE NICOLE SOUTHALL |
| Credential | RD, LD |
| Practice Address |
1353 N Westmoreland Rd Bldg F Dallas TX 75211-1655 |
| Mailing Address |
18777 Midway Rd Apt 1310 Dallas TX 75287-2742 |
| Practice Telephone | 2143337091 |
| Mailing Telephone | 8178918722 |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2009-01-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | DT80516 | TX | Dietary & Nutritional Service Providers |
| Y | 133VN1004X |
Dietitian, Registered Specialization: Nutrition, Pediatric |
DT80516 | TX | Dietary & Nutritional Service Providers |
| Street Address |
1353 N WESTMORELAND RD BLDG F |
| City | DALLAS |
| State | TX |
| Zip Code | 75211-1655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386868305 | Margaret Greenleaf Ix | Case Manager/Care Coordinator | 1353 N Westmoreland Rd Bldg F, Dallas, TX 75211-1655 | 2007-04-12 |
| 1962982017 | Samout Kettavong | Speech-Language Pathologist | 1353 N Westmoreland Rd Bldg F, Dallas, TX 75211-1655 | 2018-08-17 |
| 1114299518 | Whitney Riedel | Speech-Language Pathologist | 1353 N Westmoreland Rd Bldg F, Dallas, TX 75211-1655 | 2012-01-31 |
| 1114192606 | Harriet Gilman | Speech-Language Pathologist | 1353 N Westmoreland Rd Bldg F, Dallas, TX 75211-1655 | 2008-04-25 |
| 1770707549 | Melanie Jane Hodges | Case Manager/Care Coordinator | 1353 N Westmoreland Rd Bldg F, Dallas, TX 75211-1655 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447883863 | Cre8tive Pediatric Dental Group | Dentist | 2201 Fort Worth Avenue, Dallas, TX 75211 | 2020-02-13 |
| 1104317601 | May Amria | Dentist | 3434 W Illinois Ave Ste 307, Dallas, TX 75211 | 2018-05-21 |
| 1235547787 | Los Barrios Unidos Community Clinic, Inc | Clinic/Center | 4732 W. Illinois, Dallas, TX 75211 | 2014-07-29 |
| 1568733616 | Amit Sethi | Dentist | 4475 Adler Dr Ste 103, Dallas, TX 75211 | 2012-01-21 |
| 1265764914 | Thomas Lee Schiller | Dentist | 1441 N. Cockrell Hill Rd.., Dallas, TX 75211 | 2010-02-05 |
| 1407030570 | Sylvia Dupuy | Speech-Language Pathologist | 1353 N. Westmoreland Rd., Bldg F, Dallas, TX 75211 | 2007-12-24 |
| 1801088802 | Smile Care Orthodontics | Dentist | 4390 I-30, Ste 200, Dallas, TX 75211 | 2007-08-14 |
| 1104047364 | Ronald Leon Thomas | Pharmacist | 1350 N. Westmoreland, Pharmacy Service, Dallas, TX 75211 | 2007-05-02 |
| 1578785515 | Rabiu E Omolaja | Case Manager/Care Coordinator | 1353 N. Westmoreland Road #2, Dallas, TX 75211 | 2007-05-02 |
| 1982828687 | Yokitha Kenyetta Hamp | Counselor | 1253 Westmoreland, Dallas, TX 75211 | 2007-04-12 |
| Find all providers in zip 75211 | ||||
| Taxonomy Code | 133VN1004X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Pediatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104366970 | Janelle Marie Andonie Bocock | Dietitian, Registered | 6162 Maple Ave Apt 2308, Dallas, TX 75235-6820 | 2017-02-27 |
| 1700070620 | Inge Daeschel | Dietitian, Registered | 523 Se Washington Street, Dallas, OR 97338-2834 | 2007-09-04 |
| 1871690206 | Kamesha Burrell | Dietitian, Registered | 1935 Motor Stree, Dallas, TX 75235 | 2006-09-20 |
| 1396840856 | Elyse Marie Carson | Dietitian, Registered | 6135 La Vista Dr, Dallas, TX 75214-4310 | 2006-09-13 |
| 1629625124 | Lauren Elizabeth Hollaway | Dietitian, Registered | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2019-08-20 |
| 1750940748 | Mona Kasik | Dietitian, Registered | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2019-06-12 |
| 1629544994 | Sridevi Jagadeesan | Dietitian, Registered | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2018-10-15 |
| 1508346644 | Molly Williams | Dietitian, Registered | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2018-08-17 |
| 1063909893 | Emily Patterson | Dietitian, Registered | 1935 Medical District Dr, Dallas, TX 75235 | 2018-04-17 |
| 1316454416 | Marimar Torres | Dietitian, Registered | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2018-01-10 |
| Find all providers in DALLAS | ||||
Please comment or provide details below to improve the information on STEPHANIE NICOLE SOUTHALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.