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General NPI Number Information
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NPI Number | 1568385458
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Entity Type | Organization
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Legal Business Name | AVENA NUTRITION LLC
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 734 CAMINO LAGO
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City | IRVING
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State | TX
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Zip | 75039-3137
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Country | US
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Telephone | 832-360-7478
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Fax |
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Provider Business Mailing Address
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Address Line | 734 CAMINO LAGO
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City | IRVING
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State | TX
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Zip | 75039-3137
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SIDRA AGARWAL
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Credential | RDN, LD
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Telephone | 832-360-7478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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