Kathleen A Eustace, RD LD | |
5323 Harry Hines Blvd, Dallas, TX 75390 | |
(214) 645-5722 | |
(214) 645-7501 |
Full Name | Kathleen A Eustace |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 5323 Harry Hines Blvd, Dallas, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780976126 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | DT81625 (Texas) | Primary |
Provider Name | University Of Texas Southwestern Medical Center At Dallas |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1972579365 PECOS PAC ID: 0648188250 Enrollment ID: O20031106000792 |
Mailing Address | Practice Location Address |
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Kathleen A Eustace, RD LD Po Box 845347, Dallas, TX 75284-5347 Ph: (214) 645-5722 | Kathleen A Eustace, RD LD 5323 Harry Hines Blvd, Dallas, TX 75390 Ph: (214) 645-5722 |
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