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Organization
UP4 NUTRITION LLC
Active
Organization
UP4 NUTRITION LLC
Active
Other names
UP4 Nutrition
Organization subpart
No
Provider details
NPI number
Authorized official
UZMA WAHEED KHAN RD LD (DIETITIAN)
(469) 471-1988
Entity
Organization
Contact information
Practice address
3417 SPECTRUM BLVD, RICHARDSON, TX 75082-9705
(469) 471-1988
Mailing address
4405 BOULDER DRIVE, PARKER, TX 75002
(469) 471-1988
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
305R00000X
Preferred Provider Organization
DT07722
TX
Other
Enumeration date
03/25/2016
Last updated
07/13/2017
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