Provider Demographics
NPI:1629776570
Name:POWERD NUTRITION
Entity Type:Organization
Organization Name:POWERD NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SADAF
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAZANI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:318-267-0100
Mailing Address - Street 1:2223 HAWES AVE APT 479
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-4693
Mailing Address - Country:US
Mailing Address - Phone:318-267-0100
Mailing Address - Fax:
Practice Address - Street 1:2223 HAWES AVE APT 479
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-4693
Practice Address - Country:US
Practice Address - Phone:318-267-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, OncologyGroup - Single Specialty