Healthcare Provider Details

I. General information

NPI: 1457070021
Provider Name (Legal Business Name): ALAUNUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 NIMITZ LN
PLANO TX
75074-0314
US

IV. Provider business mailing address

1216 NIMITZ LN
PLANO TX
75074-0314
US

V. Phone/Fax

Practice location:
  • Phone: 916-759-5058
  • Fax:
Mailing address:
  • Phone: 949-696-6157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: NAZNEEN VISRAM
Title or Position: OWNER
Credential:
Phone: 949-696-6157