Provider Demographics
NPI:1568291854
Name:VARON, MOLLYE (RDN, LD)
Entity type:Individual
Prefix:
First Name:MOLLYE
Middle Name:
Last Name:VARON
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 MCKINNEY AVE APT 218
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-8511
Mailing Address - Country:US
Mailing Address - Phone:504-722-6292
Mailing Address - Fax:
Practice Address - Street 1:3201 DALLAS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9572
Practice Address - Country:US
Practice Address - Phone:469-991-9865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT90060133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered