Individual
ALICIA ELENA FARHAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RD, LD
Contact information
Practice address
1935 MEDICAL DISTRICT DR, CLINICAL NUTRITION, DALLAS, TX 75235-7701
(214) 456-3264
(214) 456-6287
Mailing address
714 LIBERTY ST APT 2812, DALLAS, TX 75204-8716
(225) 588-9532
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
1039352
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1039352
REGISTERED DIETITIAN, REGISTERED DIETITIAN NUTRITIONIST
—
01
—
DT82916
LICENSED DIETITIAN
TX
Enumeration date
01/06/2014
Last updated
01/06/2014
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