NPI 1053859306

Metabolic Therapy INC.

Organisation Clinic Pharmacy Austin, TX

Practice location

Address: 4103 Avenue D, Austin, TX 78751
Phone: (512) 909-7963
Mailing address: PO Box 66101, Austin, TX 78766-6101

Authorised official

Name: Kenneth Russell
Title: Owner
Phone: (512) 909-7963

Registered specialties

Clinic Pharmacy Primary

Suppliers Taxonomy 3336C0002X

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Registry record

NPI: 1053859306
Entity type: Organization
NPI issued: 7 Feb 2017
Record last updated: 7 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.