Functional Rd, Llc is a medicare enrolled "Dietitian, Registered" provider in Shavano Park, Texas. Their current practice location is
106 Chimney Rock Lane, Shavano Park, Texas. You can reach out to their office (for appointments etc.) via phone at
(409) 658-5028.
Functional Rd, Llc is licensed to practice in Texas (license number DT83404) and it also participates in the medicare program. Functional Rd, Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1932627312.
Healthcare Provider's Profile
| Full Name | Functional Rd, Llc |
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| Type | Facility |
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| Speciality | Dietitian, Registered |
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| Location | 106 Chimney Rock Lane, Shavano Park, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1932627312
- Provider Enumeration Date: 09/06/2017
- Last Update Date: 04/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 0648514091
- Enrollment ID: O20181212000300
Medical Identifiers
Medical identifiers for Functional Rd, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1932627312 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | DT83404 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Functional Rd, Llc acts as a billing entity for following providers:
| Provider Name | Aimee Elizabeth Senior |
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| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
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| Provider Identifiers | NPI Number: 1609225333
PECOS PAC ID: 6103160478
Enrollment ID: I20181128001257 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Functional Rd, Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Functional Rd, Llc
14439 Nw Military Hwy Ste 108,
Shavano Park, TX 78231-1648
Ph: (210) 920-0669 | Functional Rd, Llc
106 Chimney Rock Lane,
Shavano Park, TX 78231-1648
Ph: (409) 658-5028 |
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