Provider Demographics
NPI:1942263041
Name:ATENCIO, RUBEN (RPH)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:ATENCIO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 S 77 SUNSHINESTRIP
Mailing Address - Street 2:SUITE A
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8355
Mailing Address - Country:US
Mailing Address - Phone:956-423-2986
Mailing Address - Fax:
Practice Address - Street 1:2325 S 77 SUNSHINESTRIP
Practice Address - Street 2:SUITE A
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8355
Practice Address - Country:US
Practice Address - Phone:956-423-2986
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34193OtherREGISTERED PHARMACIST #