Provider Demographics
NPI:1346933702
Name:FLORES, RUBEN JUSTIN (RBT)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:JUSTIN
Last Name:FLORES
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 DOVE AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-5149
Mailing Address - Country:US
Mailing Address - Phone:956-616-7454
Mailing Address - Fax:
Practice Address - Street 1:423 DOVE AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-5149
Practice Address - Country:US
Practice Address - Phone:956-616-7454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-22-214178106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty