Healthcare Provider Details

I. General information

NPI: 1770462939
Provider Name (Legal Business Name): ENABLED NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2025
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22606 HEATHER WAY CT
KATY TX
77449-3663
US

IV. Provider business mailing address

22606 HEATHER WAY CT
KATY TX
77449-3663
US

V. Phone/Fax

Practice location:
  • Phone: 317-450-3121
  • Fax:
Mailing address:
  • Phone: 317-450-3121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: CHESLEY ROWLETT
Title or Position: OWNER
Credential:
Phone: 317-450-3121