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General NPI Number Information
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NPI Number | 1417446709
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Entity Type | Organization
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Legal Business Name | EATING RECOVERY CENTER OF TEXAS
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 4200 S HULEN ST STE 436
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City | FORT WORTH
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State | TX
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Zip | 76109-4910
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Country | US
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Telephone | 877-825-8584
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Fax |
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Provider Business Mailing Address
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Address Line | 7351 E. LOWRY BLVD STE 200
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City | DENVER
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State | CO
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Zip | 80230
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Country | US
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Telephone | 972-476-0800
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Fax | 972-985-0403
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Authorized Official
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Title or Position | MANAGER, CREDENTIALING
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Name | JESS JOSLIN
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Credential |
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Telephone | 303-731-8164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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