Provider Demographics
NPI:1720880248
Name:BABER, KIRBY NICOLE (MCN, RD, LD)
Entity type:Individual
Prefix:
First Name:KIRBY
Middle Name:NICOLE
Last Name:BABER
Suffix:
Gender:
Credentials:MCN, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 HEALEY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-3713
Mailing Address - Country:US
Mailing Address - Phone:281-701-2617
Mailing Address - Fax:
Practice Address - Street 1:2211 HEALEY DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-3713
Practice Address - Country:US
Practice Address - Phone:281-701-2617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT91150133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered