Provider Demographics
NPI:1851518310
Name:LIANO, RUBEN (PT)
Entity Type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:
Last Name:LIANO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3945 DONIPHAN PARK CIR STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1361
Mailing Address - Country:US
Mailing Address - Phone:915-760-8808
Mailing Address - Fax:915-760-8805
Practice Address - Street 1:3945 DONIPHAN PARK CIR STE A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79922-1361
Practice Address - Country:US
Practice Address - Phone:915-760-8808
Practice Address - Fax:915-760-8805
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1130193OtherLICENSE NUMBER