Healthcare Provider Details

I. General information

NPI: 1558871657
Provider Name (Legal Business Name): KATHERINE RUGGLES RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 NORTH LOOP W STE 205
HOUSTON TX
77018-8146
US

IV. Provider business mailing address

2060 NORTH LOOP W STE 205
HOUSTON TX
77018-8146
US

V. Phone/Fax

Practice location:
  • Phone: 713-622-6422
  • Fax: 888-975-5973
Mailing address:
  • Phone: 713-622-6422
  • Fax: 888-975-5973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDT84904
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: