Provider Demographics
NPI:1073191748
Name:WELLNESS INSPIRED INC
Entity Type:Organization
Organization Name:WELLNESS INSPIRED INC
Other - Org Name:DALLAS DIETITIAN NUTRITIONIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-465-5524
Mailing Address - Street 1:3208 MILE HIGH LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2699
Mailing Address - Country:US
Mailing Address - Phone:469-333-2378
Mailing Address - Fax:
Practice Address - Street 1:3208 MILE HIGH LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2699
Practice Address - Country:US
Practice Address - Phone:469-333-2378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT85638OtherSTATE LICENSE