Healthcare Provider Details

I. General information

NPI: 1598555328
Provider Name (Legal Business Name): BROOK CATHERINE LIVECCHI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 MEDICAL ARTS ST STE 9
AUSTIN TX
78705-3302
US

IV. Provider business mailing address

2911 MEDICAL ARTS ST STE 9
AUSTIN TX
78705-3302
US

V. Phone/Fax

Practice location:
  • Phone: 512-522-7793
  • Fax: 818-484-2316
Mailing address:
  • Phone: 512-522-7793
  • Fax: 818-484-2316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT90062
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: