Provider Demographics
NPI:1437420304
Name:AMERICAN NUTRITION CARE
Entity Type:Organization
Organization Name:AMERICAN NUTRITION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HIEP
Authorized Official - Middle Name:Q
Authorized Official - Last Name:THAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-767-3837
Mailing Address - Street 1:1114 E PIONEER PKWY
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-6494
Mailing Address - Country:US
Mailing Address - Phone:817-471-2640
Mailing Address - Fax:512-541-1654
Practice Address - Street 1:1114 E PIONEER PKWY
Practice Address - Street 2:SUITE 10
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6494
Practice Address - Country:US
Practice Address - Phone:817-471-2640
Practice Address - Fax:512-541-1654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable