Provider Demographics
NPI:1053962761
Name:KRILIC, GERRYL LANDRY (NBC-HWC)
Entity type:Individual
Prefix:MS
First Name:GERRYL
Middle Name:LANDRY
Last Name:KRILIC
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3975 HONEYCUTT DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1002
Mailing Address - Country:US
Mailing Address - Phone:469-269-0772
Mailing Address - Fax:
Practice Address - Street 1:FRISCOFIT CITY PREDIABETES PREVENTION FOR ALL AGES
Practice Address - Street 2:3975 HONEYCUTT DRIVE
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-7503
Practice Address - Country:US
Practice Address - Phone:469-269-0772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174H00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2083P0901XOther2083P0901X