Individual
MS. AMY CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
2401 S 31ST ST, SCOTT & WHITE HOSPITAL MS 09-CW403, TEMPLE, TX 76508-0001
(254) 724-8726
(254) 724-1425
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
(254) 215-9722
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT04104
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143893901
—
TX
Enumeration date
04/26/2007
Last updated
10/07/2020
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