Provider Demographics
NPI:1205719317
Name:HENRIOD, SIDNEY (MDA, RDN, LD)
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:
Last Name:HENRIOD
Suffix:
Gender:F
Credentials:MDA, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 JUNO LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-7731
Mailing Address - Country:US
Mailing Address - Phone:801-931-8655
Mailing Address - Fax:
Practice Address - Street 1:924 JUNO LN
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-7731
Practice Address - Country:US
Practice Address - Phone:801-931-8655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered