Provider Demographics
NPI:1124902556
Name:KYLE, JESSICA (RD, LD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:KYLE
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 1:10833 WORN SOLE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-6057
Mailing Address - Country:US
Mailing Address - Phone:940-577-4201
Mailing Address - Fax:
Practice Address - Street 1:12221 RENFERT WAY STE 250
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5657
Practice Address - Country:US
Practice Address - Phone:512-814-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered