Provider Demographics
NPI:1669332268
Name:O'CONNOR, RUTH A (LD)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:A
Last Name:O'CONNOR
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 1:155 CALETA BCH
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3833
Mailing Address - Country:US
Mailing Address - Phone:347-424-5712
Mailing Address - Fax:
Practice Address - Street 1:155 CALETA BCH
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3833
Practice Address - Country:US
Practice Address - Phone:347-424-5712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-15
Last Update Date:2025-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003044133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education