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NPI Code Detail

MEDICARE: ASHLEY FLOWERS MS RD LD

MEDICARE: ASHLEY FLOWERS MS RD LD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133VN1006XMetabolic Nutrition Registered DietitianDT81211TX
2133N00000XNutritionistDT81211TX
3133NN1002XNutrition Education NutritionistDT81211TX
4133V00000XRegistered DietitianDT81211TX

General Provider Information

NPI Number : 1477516730
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY FLOWERS MS RD LD
Provider Business Mailing Address
First Line : 400 N BEACH ST
Second Line : SUITE 100
City : FORT WORTH
State : TX
Zip : 76111-7069
Country : US
Telephone Number : 817-916-5220
Fax Number : 817-916-4662
Provider Business Practice Location Address
First Line : 400 N BEACH ST
Second Line : SUITE 100
City : FORT WORTH
State : TX
Zip : 76111-7069
Country : US
Telephone Number : 817-916-5220
Fax Number : 817-916-4662
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2006
Last Update Date : 02/15/2017

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