MEDICARE: SARAH RUIZ PHD, RD, LD, CDCES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1006X	Metabolic Nutrition Registered Dietitian	21600535
2	133V00000X	Registered Dietitian	DT83186	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073971495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH RUIZ PHD, RD, LD, CDCES

Provider Business Mailing Address
First Line	:	2601 E YANDELL DR STE 104
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79903-3743
Country	:	US
Telephone Number	:	915-262-6192
Fax Number	:	833-526-6362

Provider Business Practice Location Address
First Line	:	2601 E YANDELL DR STE 104
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79903-3743
Country	:	US
Telephone Number	:	915-262-6192
Fax Number	:	833-526-6362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2016
Last Update Date	:	01/30/2024

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Directions to “ SARAH RUIZ PHD, RD, LD, CDCES” Practice Location

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