CAROLYN WYLY (NPI# 1417241175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417241175 |
| Entity Type | Individual |
| Full Name | CAROLYN WYLY |
| Practice Address |
2620 Tanglewilde St Houston TX 77063-3203 |
| Practice Telephone | 7138608383 |
| Practice Fax Number | 7138608384 |
| Mailing Telephone | 7138608383 |
| Mailing Fax Number | 7138608384 |
| Enumeration Date | 2011-05-30 |
| Last Update Date | 2011-05-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 136A00000X | Dietetic Technician, Registered | DT04433 | TX | Dietary & Nutritional Service Providers |
| Street Address |
2620 TANGLEWILDE ST |
| City | HOUSTON |
| State | TX |
| Zip Code | 77063-3203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780992925 | La Mansion Interests Inc | Clinic/Center | 2620 Tanglewilde St, Houston, TX 77063-3203 | 2010-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104443266 | Diagnostic Enterprises | Clinical Medical Laboratory | 2540 Fondren Road, Suite 265, Houston, TX 77063 | 2020-07-06 |
| 1184247926 | Two Hands Pllc | Day Training, Developmentally Disabled Services | 3945 Braxton Dr Ste 1, Houston, TX 77063 | 2020-05-27 |
| 1700445376 | Diana Carter | Licensed Vocational Nurse | 1602 S City Oak Ln, Houston, TX 77063 | 2019-06-07 |
| 1952964264 | Pamela Lowrance | Specialist | 8401 Westhiemer Rd. #503, Inside Blue Lion Salon Studios, Houston, TX 77063 | 2019-04-22 |
| 1104381649 | Jaileen Grullon | Physical Therapy Assistant | 9638 Beverlyhill Street, Houston, TX 77063 | 2019-02-08 |
| 1134696826 | Adriane De Freitas Barroso | Psychologist | 7670 Woodway Dr Ste 360, Houston, TX 77063 | 2018-10-31 |
| 1740765932 | Sean A Maxwell | Physical Therapist | 2500 Fondern Road, Suite 302, Houston, TX 77063 | 2018-10-03 |
| 1578065074 | Johannah Sommer Garza | Psychologist | 7660 Woodway Dr Ste 599, Houston, TX 77063 | 2018-03-01 |
| 1477069995 | Modern Med Health Solutions LLC | Nurse Practitioner | 9950 Westpark Dr Ste 312, Houston, TX 77063 | 2017-12-20 |
| 1306360177 | Desmond Eugene Blake Sr. | Specialist | 3201 Fondren Rd, Houston, TX 77063 | 2017-08-02 |
| Find all providers in zip 77063 | ||||
| Taxonomy Code | 136A00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietetic Technician, Registered |
| A person trained in food and nutrition who is an integral part of health care and foodservice management teams. A dietetic technician, registered (DTR) has successfully completed at least a two-year associate’s degree at a US regionally accredited college or university; a dietetic technician program approved by The American Dietetic Association, including 450 hours of supervised practice experience; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Dietetic Technician, Registered -- a food and nutrition practitioner. Chicago, IL: The American dietetic association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588273775 | Eric Von Runnels | Dietetic Technician, Registered | 4218 Leighann Lane Dr, Houston, TX 77047-6780 | 2020-07-24 |
| 1679105514 | Blake M Herron | Dietetic Technician, Registered | 300 Pecore St Apt 21, Houston, TX 77009-6247 | 2020-02-09 |
| 1689706392 | Oliva Olivarez | Dietetic Technician, Registered | 1504 Taub Loop, Houston, TX 77030-1608 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952990 | Priscilla Ann Askew | Dietetic Technician, Registered | 3025 Roxboro Rd, Euless, TX 76039-4055 | 2018-08-16 |
| 1922641034 | Mallory Patricia Bobzien | Dietetic Technician, Registered | 9301 N Central Expy Ste 685, Dallas, TX 75231-0816 | 2019-10-21 |
| 1326405697 | Emily Peck | Dietetic Technician, Registered | 1500 Cooper St, Fort Worth, TX 76104-2710 | 2016-01-18 |
| 1568714269 | Nutrition In Action | Dietetic Technician, Registered | 9400 N. Central Expressway, Suite 402, Dallas, TX 75231 | 2012-10-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.