Most Relevant Information
Provider Data
| NPI Number: | 1003680463 |
| Provider Name: | JANET GAYTAN RD LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | DT89656 |
Most Important Dates
| Enumeration Date: | 11/07/2023 |
| Last Updated: | 06/13/2024 |
Provider Practice Location
2600 E BERRY ST
FORT WORTH
TX
761054750
Practice Location Phone/Fax
| Phone: | 8173474600 |
| Fax: | 8173474639 |
Provider Mailing Location
PO BOX 733784
DALLAS
TX
753733784
Provider Mailing Phone/Fax
| Phone: | 6828856483 |
| Fax: | 6828853113 |