Organization
MEDINA COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE THACKER III (MANAGER, NUTRITION CENTER)
(830) 741-6160
Entity
Organization
Contact information
Practice address
808A HARPER, HONDO, TX 78861-2000
(830) 741-6160
(830) 741-6164
Mailing address
808A HARPER, HONDO, TX 78861-2000
(830) 741-6160
(830) 741-6164
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
—
—
Other
Enumeration date
06/20/2007
Last updated
08/22/2020
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