Individual provider · NPI-1

Jessica G. Acosta, MS, RD, LD

Dietitian, Registered · San Antonio, TX

NPI number1609091040
StatusActive
Last updated in NPPESMar 19, 2010

Details

NPI
1609091040
Entity type
Individual (NPI-1)
Name
Jessica G. Acosta
Credential
MS, RD, LD
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 13, 2007
Last updated
Mar 19, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered968469TXYes

Practice location

14207 Higgins Rd
San Antonio, TX 78217-1252

Phone 210-826-4492

Mailing address

2203 Babcock Rd
San Antonio, TX 78229-4412

Phone 210-643-6792

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