Provider Demographics
NPI:1285153981
Name:DAILEY, JASMINE (MPH, RD, CHES)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:DAILEY
Suffix:
Gender:F
Credentials:MPH, RD, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 W T C JESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-5044
Mailing Address - Country:US
Mailing Address - Phone:915-497-2546
Mailing Address - Fax:
Practice Address - Street 1:3403 W T C JESTER BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-5044
Practice Address - Country:US
Practice Address - Phone:915-497-2546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000898133V00000X
TXDT86031133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered