Provider Demographics
NPI:1265008619
Name:USHINE NUTRITION LLC
Entity Type:Organization
Organization Name:USHINE NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:XIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:405-339-4808
Mailing Address - Street 1:2926 BARKER CYPRESS RD APT 5108
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7939
Mailing Address - Country:US
Mailing Address - Phone:405-339-4808
Mailing Address - Fax:
Practice Address - Street 1:2926 BARKER CYPRESS RD APT 5108
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7939
Practice Address - Country:US
Practice Address - Phone:405-339-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center