Healthcare Provider Details

I. General information

NPI: 1073971495
Provider Name (Legal Business Name): SARAH RUIZ PHD, RD, LD, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 E YANDELL DR STE 104
EL PASO TX
79903-3743
US

IV. Provider business mailing address

2601 E YANDELL DR STE 104
EL PASO TX
79903-3743
US

V. Phone/Fax

Practice location:
  • Phone: 915-262-6192
  • Fax: 833-526-6362
Mailing address:
  • Phone: 915-262-6192
  • Fax: 833-526-6362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number21600535
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT83186
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: