Healthcare Provider Details

I. General information

NPI: 1194555482
Provider Name (Legal Business Name): NATIONAL NUTRITION CONSULTANTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 LAVACA ST UNIT 7032
AUSTIN TX
78701-1634
US

IV. Provider business mailing address

1401 LAVACA STREET UNIT 7032
AUSTIN TX
78701-1634
US

V. Phone/Fax

Practice location:
  • Phone: 512-798-8917
  • Fax: 512-265-9012
Mailing address:
  • Phone: 512-798-8917
  • Fax: 512-265-9012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: LAURA S WALKER
Title or Position: AUTHORIZED OFFICIAL
Credential: RD
Phone: 512-338-4500