Provider Demographics
NPI:1386337582
Name:EVILSIZER, HAWLEY S (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:HAWLEY
Middle Name:S
Last Name:EVILSIZER
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 1:12717 CORALBERRY CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2196
Mailing Address - Country:US
Mailing Address - Phone:512-468-3810
Mailing Address - Fax:
Practice Address - Street 1:12717 CORALBERRY CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-2196
Practice Address - Country:US
Practice Address - Phone:512-468-3810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07001133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered