Healthcare Provider Details

I. General information

NPI: 1679361315
Provider Name (Legal Business Name): EATING WITH BRACHA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18024 CARROLLWOOD DR
DALLAS TX
75252-6330
US

IV. Provider business mailing address

18024 CARROLLWOOD DR
DALLAS TX
75252-6330
US

V. Phone/Fax

Practice location:
  • Phone: 516-784-9271
  • Fax:
Mailing address:
  • Phone: 516-784-9271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: BRACHA BROWN
Title or Position: CEO
Credential:
Phone: 972-695-3663