Individual
MRS. SUSAN THOMAS JASTROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
1242 PT RANCH RD, ROUND MOUNTAIN, TX 78663-5990
(512) 466-4407
Mailing address
1242 PT RANCH ROAD, ROUND MOUNTAIN, TX 78663-5990
(512) 466-4407
(830) 825-2400
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT04706
TX
Other
Enumeration date
05/07/2009
Last updated
04/25/2013
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