MEDICARE: DALLAS NUTRITION THERAPY

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

General Provider Information

NPI Number	:	1235486184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS NUTRITION THERAPY

Provider Business Mailing Address
First Line	:	3636 N MACARTHUR BLVD STE 120
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-3691
Country	:	US
Telephone Number	:	469-565-2539
Fax Number	:	469-565-2540

Provider Business Practice Location Address
First Line	:	3636 N MACARTHUR BLVD STE 120
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-3691
Country	:	US
Telephone Number	:	682-239-7255
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SAMIRA AMLANI
Credential	:
Telephone Number	:	682-239-7255

Provider Enumeration Date	:	08/09/2012
Last Update Date	:	01/16/2025

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Directions to “DALLAS NUTRITION THERAPY ” Practice Location

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