MEDICARE: MARY E BELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	DT04217	TX

General Provider Information

NPI Number	:	1144619867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY E BELL

Provider Business Mailing Address
First Line	:	1011 CITRINE CV
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-2272
Country	:	US
Telephone Number	:	972-880-8443
Fax Number	:	469-362-0875

Provider Business Practice Location Address
First Line	:	1011 CITRINE CV
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-2272
Country	:	US
Telephone Number	:	972-880-8443
Fax Number	:	469-362-0875

Authorized Official
Title or Position	:	OWNER
Name	:	MARY E CABRAL
Credential	:	RD, LD
Telephone Number	:	972-880-8443

Provider Enumeration Date	:	01/19/2015
Last Update Date	:	01/19/2015

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