Provider Demographics
NPI:1528431541
Name:TOOMAY, JILLIAN (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:
Last Name:TOOMAY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:BESTIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:7622 MIDBURY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3210
Mailing Address - Country:US
Mailing Address - Phone:214-673-5584
Mailing Address - Fax:
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:CLINICAL NUTRITION
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-673-5584
Practice Address - Fax:214-456-6287
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07596133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT07596OtherLICENSED DIETITIAN