Most Relevant Information
Provider Data
| NPI Number: | 1003381286 |
| Provider Name: | JOSEPH JAMIE IBARRA MCN, RDN, LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86146437 |
Most Important Dates
| Enumeration Date: | 10/03/2018 |
| Last Updated: | 10/03/2018 |
Provider Practice Location
2528 MARINA DR
GRAND PRAIRIE
TX
750546851
Practice Location Phone/Fax
| Phone: | 9096361340 |
| Fax: |
Provider Mailing Location
2528 MARINA DR
GRAND PRAIRIE
TX
750546851
Provider Mailing Phone/Fax
| Phone: | 9096361340 |
| Fax: |