Provider Demographics
NPI:1528748456
Name:CARTINO, TIFFANY (RDN)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:CARTINO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 STABLE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-2962
Mailing Address - Country:US
Mailing Address - Phone:757-472-1025
Mailing Address - Fax:
Practice Address - Street 1:711 STABLE GLEN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245-2962
Practice Address - Country:US
Practice Address - Phone:757-472-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1096848133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered