Provider Demographics
NPI:1659252435
Name:MCANELLY, MINA (MS, RDN, LD)
Entity type:Individual
Prefix:MRS
First Name:MINA
Middle Name:
Last Name:MCANELLY
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 INDEPENDENCE PARKWAY
Mailing Address - Street 2:SUITE 156 #602
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025
Mailing Address - Country:US
Mailing Address - Phone:972-322-5684
Mailing Address - Fax:
Practice Address - Street 1:5213 OLD SHEPARD PL
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5002
Practice Address - Country:US
Practice Address - Phone:972-322-5684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85404133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty