MEDICARE: BUEN PROVECHO NUTRITION SERVICES, 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	:	1588525810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUEN PROVECHO NUTRITION SERVICES, LLC

Provider Business Mailing Address
First Line	:	112 GREEN EGRET WAY
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78641-4519
Country	:	US
Telephone Number	:	512-945-1838
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 GREEN EGRET WAY
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78641-4519
Country	:	US
Telephone Number	:	512-945-1838
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	MAYRA GARCIA ZEDA
Credential	:	RDN
Telephone Number	:	512-945-1838

Provider Enumeration Date	:	11/18/2025
Last Update Date	:	02/10/2026

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