Provider Demographics
NPI:1215205349
Name:SHANKLIN, RUTH (LD)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:
Last Name:SHANKLIN
Suffix:
Gender:F
Credentials:LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 TEAL RUN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-2027
Mailing Address - Country:US
Mailing Address - Phone:832-758-0442
Mailing Address - Fax:713-729-8560
Practice Address - Street 1:6363 TEAL RUN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-2027
Practice Address - Country:US
Practice Address - Phone:832-758-0442
Practice Address - Fax:713-729-8560
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-03
Last Update Date:2011-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist