NPI 1104629617

Jequithia L Sims, NDTR

Practitioner Registered Dietetic Technician Grand Prairie, TX

Practice location

Address: 2952 Trail Lake Dr, Grand Prairie, TX 75054-5570
Phone: (214) 687-7203

Registered specialties

Registered Dietetic Technician Primary

Dietary & Nutritional Service Providers Taxonomy 136A00000X Licence 86170507 (TX)

Other Dietetic Technician, Registered providers in Texas →

Registry record

NPI: 1104629617
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Mar 2025
Record last updated: 31 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.