Individual
MINDY DILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2431 S LOOP 289, LUBBOCK, TX 79423-1519
(806) 771-7661
Mailing address
2431 S LOOP 289, LUBBOCK, TX 79423-1519
(806) 771-7661
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
DT83120
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337183301
—
TX
01
—
8EG102
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/04/2014
Last updated
10/30/2014
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