| Heather Rowley Rd Ld Llc | |
|
9330 Avery Ranch Way Justin TX 76247-6653 | |
| (817) 727-9652 | |
| (940) 828-1460 |
| Full Name | Heather Rowley Rd Ld Llc |
|---|---|
| Speciality | Dietitian, Registered |
| Location | 9330 Avery Ranch Way, Justin, Texas |
| Authorized Official Name and Position | Heather Rowley (OWNER) |
| Authorized Official Contact | 8177279652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heather Rowley Rd Ld Llc 9330 Avery Ranch Way Justin TX 76247-6653 Ph: (817) 727-9652 | Heather Rowley Rd Ld Llc 9330 Avery Ranch Way Justin TX 76247-6653 Ph: (817) 727-9652 |
| NPI Number | 1609637115 |
|---|---|
| Provider Enumeration Date | 01/22/2024 |
| Last Update Date | 03/06/2024 |
| Medicare PECOS PAC ID | 2961849666 |
|---|---|
| Medicare Enrollment ID | O20240318000652 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609637115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Heather Hackett Rowley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1942775788 PECOS PAC ID: 2365786894 Enrollment ID: I20181210002287 |
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