Provider Demographics
NPI:1568714269
Name:NUTRITION IN ACTION
Entity Type:Organization
Organization Name:NUTRITION IN ACTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:NUTRITIONIST
Authorized Official - Phone:432-349-8102
Mailing Address - Street 1:9400 N. CENTRAL EXPRESSWAY
Mailing Address - Street 2:SUITE 402
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:432-349-8102
Mailing Address - Fax:972-559-3634
Practice Address - Street 1:9400 N. CENTRAL EXPRESSWAY
Practice Address - Street 2:SUITE 402
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:432-349-8102
Practice Address - Fax:972-559-3634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1016859136A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, RegisteredGroup - Single Specialty