Provider Demographics
NPI:1487910303
Name:MOORE, ELZBIETA ZUZANNA (PHD, MS, CMSHN)
Entity type:Individual
Prefix:DR
First Name:ELZBIETA
Middle Name:ZUZANNA
Last Name:MOORE
Suffix:
Gender:F
Credentials:PHD, MS, CMSHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 OLD MANCHACA RD.
Mailing Address - Street 2:STE 708
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748
Mailing Address - Country:US
Mailing Address - Phone:337-415-0943
Mailing Address - Fax:
Practice Address - Street 1:10801 OLD MANCHACA RD
Practice Address - Street 2:STE 708
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-1500
Practice Address - Country:US
Practice Address - Phone:337-415-0943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist