Provider Demographics
NPI:1447072921
Name:GAAR, KENYON OWEN (RD, LD)
Entity type:Individual
Prefix:
First Name:KENYON
Middle Name:OWEN
Last Name:GAAR
Suffix:
Gender:M
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 1:2000 E ARAPAHO RD APT 4102
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-3189
Mailing Address - Country:US
Mailing Address - Phone:308-352-6921
Mailing Address - Fax:
Practice Address - Street 1:2000 E ARAPAHO RD APT 4102
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3189
Practice Address - Country:US
Practice Address - Phone:308-352-6921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT91197133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered