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NPI 1093662645

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Back2basics Functional Nutrition

NPI 1093662645 · Nutritionist · Irving, TX

Provider details

NPI number: 1093662645
Entity type: Organization
Primary specialty: NutritionistDietary & Nutritional Service Providers
Authorized official: Niti Shah, Owner

Practice location

3365 Regent Blvd Ste 130

Irving, TX 75063-3127

Phone: (972) 514-7956

Fax: (972) 366-7946

More TX providers

Mailing address

3365 Regent Blvd Ste 130

Irving, TX 75063-3127

Registry dates

Enumerated: 2026-03-12
Last updated: 2026-04-13

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Back2basics Functional Nutrition — NPI 1093662645, Irving, TX | NPI Central