Provider Demographics
NPI:1568685774
Name:RUIZ, CONNIE ELIFF (PHD REG DIETITIAN)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:ELIFF
Last Name:RUIZ
Suffix:
Gender:F
Credentials:PHD REG DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-3826
Mailing Address - Country:US
Mailing Address - Phone:409-385-3510
Mailing Address - Fax:409-386-5751
Practice Address - Street 1:1005 N 7TH ST
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-3826
Practice Address - Country:US
Practice Address - Phone:409-385-3510
Practice Address - Fax:409-386-5751
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT00825133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered