Provider Demographics
NPI:1538930623
Name:HARRIS, ISABELLE VAL (RD, RDN)
Entity type:Individual
Prefix:
First Name:ISABELLE
Middle Name:VAL
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10727 DOMAIN DR APT 516
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5064
Mailing Address - Country:US
Mailing Address - Phone:956-466-8378
Mailing Address - Fax:
Practice Address - Street 1:10727 DOMAIN DR APT 516
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5064
Practice Address - Country:US
Practice Address - Phone:956-466-8378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT89202133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered