Provider Demographics
NPI:1740949601
Name:NORTH TEXAS NUTRITION ASSOCIATES
Entity type:Organization
Organization Name:NORTH TEXAS NUTRITION ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:NASHATKER
Authorized Official - Last Name:TOM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDE
Authorized Official - Phone:843-509-6574
Mailing Address - Street 1:1021 REDWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-6103
Mailing Address - Country:US
Mailing Address - Phone:214-884-5201
Mailing Address - Fax:214-276-7503
Practice Address - Street 1:1021 REDWOOD TRL
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-6103
Practice Address - Country:US
Practice Address - Phone:214-884-5201
Practice Address - Fax:214-276-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty