Provider Demographics
NPI:1003860628
Name:ABEYTA, RUBEN QUINTENAR JR (DPT)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:QUINTENAR
Last Name:ABEYTA
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 ARENAS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88022-9725
Mailing Address - Country:US
Mailing Address - Phone:505-313-3438
Mailing Address - Fax:
Practice Address - Street 1:114 E MOTEL DR
Practice Address - Street 2:
Practice Address - City:LORDSBURG
Practice Address - State:NM
Practice Address - Zip Code:88045-1919
Practice Address - Country:US
Practice Address - Phone:505-313-3438
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist