Provider Demographics
NPI:1578210605
Name:LENZ, RUTH MERRILL (RD, LD)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:MERRILL
Last Name:LENZ
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18980 W MEMORIAL DR
Mailing Address - Street 2:STE 100
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4394
Mailing Address - Country:US
Mailing Address - Phone:832-644-8930
Mailing Address - Fax:855-227-3506
Practice Address - Street 1:18648 MCKAY DR STE 110
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5724
Practice Address - Country:US
Practice Address - Phone:832-644-8930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT86307133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered