Provider Demographics
NPI:1043063878
Name:SCHMIDT, KRISTINA (RD/LD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5358
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5358
Mailing Address - Country:US
Mailing Address - Phone:956-362-5673
Mailing Address - Fax:956-362-2038
Practice Address - Street 1:5500 RAPHAEL DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1407
Practice Address - Country:US
Practice Address - Phone:956-362-5673
Practice Address - Fax:956-362-2038
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1092264133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered