Provider Demographics
NPI:1528432176
Name:GUGGARI, MAHADEVI M (MS, RD, LD, CNSC)
Entity type:Individual
Prefix:
First Name:MAHADEVI
Middle Name:M
Last Name:GUGGARI
Suffix:
Gender:F
Credentials:MS, RD, LD, CNSC
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:GUGGARI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13709 FLAT TOP RANCH RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1913
Mailing Address - Country:US
Mailing Address - Phone:512-965-2126
Mailing Address - Fax:
Practice Address - Street 1:13709 FLAT TOP RANCH RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1913
Practice Address - Country:US
Practice Address - Phone:512-965-2126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT04150133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered