Provider Demographics
NPI:1184065864
Name:JAMALABAD, ROSIMEIRY D (RDN, LD, CDCES)
Entity type:Individual
Prefix:
First Name:ROSIMEIRY
Middle Name:D
Last Name:JAMALABAD
Suffix:
Gender:F
Credentials:RDN, LD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 ARROW WOOD RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4884
Mailing Address - Country:US
Mailing Address - Phone:512-922-5618
Mailing Address - Fax:512-843-0039
Practice Address - Street 1:1 CHISHOLM TRAIL ROAD SUITE #450
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4884
Practice Address - Country:US
Practice Address - Phone:512-922-5618
Practice Address - Fax:512-246-9704
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
911696133V00000X
TX21420625133VN1006X
TXDT06312133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
911696OtherCOMMISSION ON DIETETIC REGISTRATION - ACADEMY OF NUTRITION AND DIETETICS
21420625OtherNCBDE - NATIONAL CERTIFICATION BOARD OF DIABETES EDUCATORS
TXDT06312OtherTEXAS DEPARTMENT OF LICENSING AND REGULATION