Provider Demographics
NPI:1518037548
Name:HEALTHY CHANGES INC
Entity Type:Organization
Organization Name:HEALTHY CHANGES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:N
Authorized Official - Last Name:MCNEILL
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:972-739-3001
Mailing Address - Street 1:9229 LYNDON B JOHNSON FWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3405
Mailing Address - Country:US
Mailing Address - Phone:972-739-3097
Mailing Address - Fax:972-739-2673
Practice Address - Street 1:321 WESTPARK WAY
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3902
Practice Address - Country:US
Practice Address - Phone:214-808-3427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W071Medicare ID - Type Unspecified