Individual
JOHN A RUIBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RD, CSSD
Contact information
Practice address
3851 ROGER BROOKE DRIVE, ATTN: MCHE-QD CREDENTIALS, FORT SAM HOUSTON, TX 78234-6200
(210) 916-5909
Mailing address
8408 TAYSIDE CT, FORT WORTH, TX 76179-3153
(682) 367-5853
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT06991
TX
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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