MEDICARE: AMERICAN NUTRITION CARE

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	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1437420304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN NUTRITION CARE

Provider Business Mailing Address
First Line	:	1114 E PIONEER PKWY
Second Line	:	SUITE 10
City	:	ARLINGTON
State	:	TX
Zip	:	76010-6494
Country	:	US
Telephone Number	:	817-471-2640
Fax Number	:	512-541-1654

Provider Business Practice Location Address
First Line	:	1114 E PIONEER PKWY
Second Line	:	SUITE 10
City	:	ARLINGTON
State	:	TX
Zip	:	76010-6494
Country	:	US
Telephone Number	:	817-471-2640
Fax Number	:	512-541-1654

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. HIEP Q THAI
Credential	:
Telephone Number	:	469-767-3837

Provider Enumeration Date	:	01/24/2012
Last Update Date	:	01/24/2012

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Directions to “AMERICAN NUTRITION CARE ” Practice Location

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