Organization
LUMINARY NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELORA BAZANELE MS, RD, LD (OWNER)
(972) 926-3683
Entity
Organization
Contact information
Practice address
1820 PRESTON PARK BLVD STE 2200, PLANO, TX 75093-3614
(972) 926-3683
(972) 920-6765
Mailing address
1820 PRESTON PARK BLVD STE 2200, PLANO, TX 75093-3614
(972) 926-3683
(972) 920-6765
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/08/2019
Last updated
01/04/2021
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