Provider Demographics
NPI:1992386411
Name:RURAL RD
Entity Type:Organization
Organization Name:RURAL RD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ERRIN
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:MINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD
Authorized Official - Phone:806-577-6097
Mailing Address - Street 1:978 US HIGHWAY 287
Mailing Address - Street 2:
Mailing Address - City:CLAUDE
Mailing Address - State:TX
Mailing Address - Zip Code:79019-3631
Mailing Address - Country:US
Mailing Address - Phone:806-577-6097
Mailing Address - Fax:
Practice Address - Street 1:978 US HIGHWAY 287
Practice Address - Street 2:
Practice Address - City:CLAUDE
Practice Address - State:TX
Practice Address - Zip Code:79019-3631
Practice Address - Country:US
Practice Address - Phone:806-577-6097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDT82168OtherLICENSE