Provider Demographics
NPI:1679937635
Name:WHITE, VICTORIA (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:8701 MENCHACA RD STE 201
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5383
Mailing Address - Country:US
Mailing Address - Phone:512-640-9503
Mailing Address - Fax:
Practice Address - Street 1:8701 MENCHACA RD STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5383
Practice Address - Country:US
Practice Address - Phone:512-640-9503
Practice Address - Fax:888-395-1028
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT82863133V00000X
TX1065533133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered