Individual
TAMMY JIMENEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, IBCLC, CPM,
Contact information
Practice address
5555 W. TWIN LAKES DR., TYLER, TX 75704
(409) 382-7040
(903) 496-0361
Mailing address
5555 W TWIN LAKES DR., TYLER, TX 75704
(409) 382-7040
(903) 496-0361
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DT07165
TX
174N00000X
Lactation Consultant (Non-RN)
L-17418
—
174N00000X
Lactation Consultant (Non-RN)
—
—
176B00000X
Midwife
Primary
99311
TX
Other
Enumeration date
01/10/2007
Last updated
10/20/2017
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