Provider Demographics
NPI:1598555328
Name:LIVECCHI, BROOK CATHERINE
Entity type:Individual
Prefix:
First Name:BROOK
Middle Name:CATHERINE
Last Name:LIVECCHI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 CAMERON RD APT 3006
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-0078
Mailing Address - Country:US
Mailing Address - Phone:210-445-1396
Mailing Address - Fax:
Practice Address - Street 1:5900 CAMERON RD APT 3006
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-0078
Practice Address - Country:US
Practice Address - Phone:210-445-1396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT90062133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered