MEDICARE: MRS. JUDY M. CHO BCHN, FNTP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	132700000X	Dietary Manager
3	133N00000X	Nutritionist
4	171400000X	Health & Wellness Coach
5	174200000X	Meals Provider
6	174H00000X	Health Educator
7	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1558089573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JUDY M. CHO BCHN, FNTP

Provider Business Mailing Address
First Line	:	11900 JOLLYVILLE RD UNIT 200782
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78720-5033
Country	:	US
Telephone Number	:	512-522-2136
Fax Number	:

Provider Business Practice Location Address
First Line	:	11801 DOMAIN BLVD FL 3
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-3430
Country	:	US
Telephone Number	:	512-522-2136
Fax Number	:

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

Provider Enumeration Date	:	08/16/2022
Last Update Date	:	09/01/2022

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