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Individual

JACQUELINE AYOUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4301 BURNET RD STE A, AUSTIN, TX 78756-3317
(512) 980-0590
(512) 598-5306
Mailing address
1602 EDGEWOOD AVE, AUSTIN, TX 78722
(512) 980-0590
(512) 598-5306

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT82549
TX
133V00000X
Registered Dietitian
DT8259
TX
133V00000X
Registered Dietitian

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DT82549
LD LICENSE
TX
Enumeration date
06/17/2014
Last updated
06/27/2020
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