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General NPI Number Information
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NPI Number | 1588525810
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Entity Type | Organization
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Legal Business Name | BUEN PROVECHO NUTRITION SERVICES, LLC
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 112 GREEN EGRET WAY
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City | LEANDER
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State | TX
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Zip | 78641-4519
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Country | US
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Telephone | 512-945-1838
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Fax |
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Provider Business Mailing Address
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Address Line | 112 GREEN EGRET WAY
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City | LEANDER
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State | TX
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Zip | 78641-4519
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Country | US
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Telephone | 512-945-1838
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | MAYRA GARCIA ZEDA
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Credential | RDN
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Telephone | 512-945-1838
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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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