Provider Demographics
NPI:1710668702
Name:LIVE NOURISHED TODAY
Entity Type:Organization
Organization Name:LIVE NOURISHED TODAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD
Authorized Official - Phone:512-785-2264
Mailing Address - Street 1:1213 RAINBOW PARKE DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-8021
Mailing Address - Country:US
Mailing Address - Phone:512-785-2264
Mailing Address - Fax:
Practice Address - Street 1:1213 RAINBOW PARKE DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8021
Practice Address - Country:US
Practice Address - Phone:512-785-2264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty