Provider Demographics
NPI:1386323004
Name:BORUS, JULIE NELSON (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:NELSON
Last Name:BORUS
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4542 BELFORT AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-3619
Mailing Address - Country:US
Mailing Address - Phone:214-334-7441
Mailing Address - Fax:
Practice Address - Street 1:16980 DALLAS PKWY STE 204
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1910
Practice Address - Country:US
Practice Address - Phone:214-334-7441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801418133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered