Healthcare Provider Details

I. General information

NPI: 1962964296
Provider Name (Legal Business Name): SUN CITY DIETITIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
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 Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DR. SARAH L RUIZ
Title or Position: OWNER
Credential: PHD, RD, LD, CDCES
Phone: 915-262-6192