Provider Demographics
NPI:1013630763
Name:BAULIER, MORGAN (RD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BAULIER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:BOWER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:17060 DALLAS PKWY STE 112
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1905
Mailing Address - Country:US
Mailing Address - Phone:469-372-2022
Mailing Address - Fax:833-290-5413
Practice Address - Street 1:17060 DALLAS PKWY STE 112
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1905
Practice Address - Country:US
Practice Address - Phone:469-372-2022
Practice Address - Fax:833-290-5413
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT87824133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered