Provider Demographics
NPI:1013394329
Name:MURPHY, AMBER M (RD, LD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:M
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:MINT
Other - Middle Name:NUTRITION
Other - Last Name:SERVICES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4709 PARKHAVEN DR
Mailing Address - Street 2:MINT NUTRITION SERVICES, LLC
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043
Mailing Address - Country:US
Mailing Address - Phone:214-676-8263
Mailing Address - Fax:214-571-4546
Practice Address - Street 1:2435 N. CENTRAL EXPWY
Practice Address - Street 2:12TH FLOOR
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75043
Practice Address - Country:US
Practice Address - Phone:214-676-8263
Practice Address - Fax:214-571-4546
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
TXDT83580133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered