Provider Demographics
NPI:1215484217
Name:DARBY, STEPHANIE L (RD, LD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:DARBY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7716 TOVAR DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-8019
Mailing Address - Country:US
Mailing Address - Phone:214-934-0018
Mailing Address - Fax:
Practice Address - Street 1:7716 TOVAR DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-8019
Practice Address - Country:US
Practice Address - Phone:512-910-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT84384133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered