MEDICARE: KATE LEVENTRY MORTON RD

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	5344	AL

General Provider Information

NPI Number	:	1346018108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE LEVENTRY MORTON RD

Provider Business Mailing Address
First Line	:	7402 ACELA TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-4591
Country	:	US
Telephone Number	:	512-694-8177
Fax Number	:

Provider Business Practice Location Address
First Line	:	7402 ACELA TRL
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-4591
Country	:	US
Telephone Number	:	512-694-8177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2023
Last Update Date	:	12/12/2023

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