Provider Demographics
NPI:1831326354
Name:NATURAL FOODS AND NUTRITION CONSULTING, LLC
Entity type:Organization
Organization Name:NATURAL FOODS AND NUTRITION CONSULTING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MIKA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CN
Authorized Official - Phone:817-805-0226
Mailing Address - Street 1:PO BOX 93343
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-0113
Mailing Address - Country:US
Mailing Address - Phone:817-805-0226
Mailing Address - Fax:
Practice Address - Street 1:6301 CAMPUS CIRCLE DR E
Practice Address - Street 2:100A
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2712
Practice Address - Country:US
Practice Address - Phone:817-805-0226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0022505133V00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty