Individual provider · NPI-1

Jacqueline S Carder, RD, LD

Dietitian, Registered, Nutrition, Renal · San Antonio, TX

NPI number1417025016
StatusActive
Last updated in NPPESAug 15, 2013

Details

NPI
1417025016
Entity type
Individual (NPI-1)
Name
Jacqueline S Carder
Credential
RD, LD
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 1, 2006
Last updated
Aug 15, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133VN1005X Dietitian, Registered, Nutrition, RenalDT81640TXYes
133NN1002X Nutritionist, Nutrition, EducationDT81640TX
133VN1006X Dietitian, Registered, Nutrition, MetabolicDT81640TX

Practice location

13214 Loma Vallejo
San Antonio, TX 78233-2418

Phone 402-429-3543 · Fax 210-579-6489

Mailing address

13214 Loma Vallejo
San Antonio, TX 78233-2418

Phone 402-429-3543 · Fax 210-579-6489

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