Provider Demographics
NPI:1003029570
Name:BAUTISTA, RUBEN ISIDRO (LPT)
Entity Type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:ISIDRO
Last Name:BAUTISTA
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20111 EAGLE GROVE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379
Mailing Address - Country:US
Mailing Address - Phone:281-351-3905
Mailing Address - Fax:281-251-3905
Practice Address - Street 1:7333 NORTH FREEWAY #290
Practice Address - Street 2:METROPOLITAN PHYSICAL THERAPY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076
Practice Address - Country:US
Practice Address - Phone:713-691-7368
Practice Address - Fax:713-691-0527
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1101491225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist