Healthcare Provider Details

I. General information

NPI: 1760218374
Provider Name (Legal Business Name): MNT ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 12/07/2024
Certification Date: 12/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 S SEVEN POINTS DR STE 10
SEVEN POINTS TX
75143-9117
US

IV. Provider business mailing address

1623 OLYMPIC DR
LONGVIEW TX
75605-2748
US

V. Phone/Fax

Practice location:
  • Phone: 214-432-5633
  • Fax: 903-205-8541
Mailing address:
  • Phone: 269-290-5396
  • Fax: 903-205-8541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHRYN MAY MCKINNEY
Title or Position: OWNER
Credential: RDN, LDN, CDCES
Phone: 903-918-0120