Provider Demographics
NPI:1962408575
Name:PREECE, RUTH DIANE (NURSE PRACTIONER)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:DIANE
Last Name:PREECE
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 650859
Mailing Address - Street 2:DEPT 710
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0859
Mailing Address - Country:US
Mailing Address - Phone:409-772-2222
Mailing Address - Fax:
Practice Address - Street 1:929 GESSNER RD
Practice Address - Street 2:SUITE 2225
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2515
Practice Address - Country:US
Practice Address - Phone:713-365-2900
Practice Address - Fax:713-984-6525
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP109069363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8E0329Medicare ID - Type Unspecified