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Individual

MS. MARSHA JEHUNG UNGCHUSRI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LD

Contact information

Practice address
1935 MEDICAL DISTRICT DR, CLINICAL NUTRITION D2.03, DALLAS, TX 75235-7701
(214) 456-0314
(214) 456-6287
Mailing address
1935 MEDICAL DISTRICT DR, CLINICAL NUTRITION D2.03, DALLAS, TX 75235-7701
(214) 456-0314
(214) 456-6287

Taxonomy

Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
#DT83498
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
#DT83498
LICENSED DIETITIAN
TX
01
86014194
REGISTERED DIETITIAN
TX
Enumeration date
10/30/2014
Last updated
10/30/2014
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