MEDICARE: ABILITY NUTRITION THERAPY LLC

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	:	1346932225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABILITY NUTRITION THERAPY LLC

Provider Business Mailing Address
First Line	:	1101 W 34TH ST # 165
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1907
Country	:	US
Telephone Number	:	512-337-3774
Fax Number	:	512-539-2799

Provider Business Practice Location Address
First Line	:	3012 WOOD SPRINGS LN
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-3909
Country	:	US
Telephone Number	:	512-924-2834
Fax Number	:

Authorized Official
Title or Position	:	OWNER/REGISTERED DIETITIAN
Name	:	ABIGAIL PLOCH
Credential	:	RD, LD
Telephone Number	:	512-924-2834

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	05/22/2023

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