Provider Demographics
NPI:1386327567
Name:BAIRD, MAKAYLA MARIE (RD, LD)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:MARIE
Last Name:BAIRD
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 1:202 CHILDERS DR APT 1022
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602-4123
Mailing Address - Country:US
Mailing Address - Phone:832-712-3080
Mailing Address - Fax:
Practice Address - Street 1:202 CHILDERS DR APT 1022
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4123
Practice Address - Country:US
Practice Address - Phone:832-712-3080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88720133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered