MEDICARE: HEALTHY CHANGES INC

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	:	1356411359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHY CHANGES INC

Provider Business Mailing Address
First Line	:	9229 LYNDON B JOHNSON FWY
Second Line	:	SUITE 250
City	:	DALLAS
State	:	TX
Zip	:	75243-3405
Country	:	US
Telephone Number	:	972-739-3097
Fax Number	:	972-739-2673

Provider Business Practice Location Address
First Line	:	1645 N TOWN EAST BLVD
Second Line	:	SUITE 503
City	:	MESQUITE
State	:	TX
Zip	:	75150-4158
Country	:	US
Telephone Number	:	214-808-3427
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARY N. MCNEILL
Credential	:	RD
Telephone Number	:	972-739-3001

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	08/08/2007

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Directions to “HEALTHY CHANGES INC ” Practice Location

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