Provider Demographics
NPI:1144619867
Name:MARY E BELL
Entity Type:Organization
Organization Name:MARY E BELL
Other - Org Name:RUDOG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:CABRAL
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:972-880-8443
Mailing Address - Street 1:1011 CITRINE CV
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2272
Mailing Address - Country:US
Mailing Address - Phone:972-880-8443
Mailing Address - Fax:469-362-0875
Practice Address - Street 1:1011 CITRINE CV
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-2272
Practice Address - Country:US
Practice Address - Phone:972-880-8443
Practice Address - Fax:469-362-0875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT04217133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty