Provider Demographics
NPI:1154129534
Name:NORTH TEXAS NUTRITION LLC
Entity type:Organization
Organization Name:NORTH TEXAS NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTABELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARDELOZA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD
Authorized Official - Phone:214-601-7057
Mailing Address - Street 1:3613 WAYNOKA DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2793
Mailing Address - Country:US
Mailing Address - Phone:214-601-7057
Mailing Address - Fax:
Practice Address - Street 1:3613 WAYNOKA DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2793
Practice Address - Country:US
Practice Address - Phone:214-601-7057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty