Provider Demographics
NPI:1982840393
Name:ABANTO, PEDRO RUBEN (MD)
Entity Type:Individual
Prefix:
First Name:PEDRO
Middle Name:RUBEN
Last Name:ABANTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4302 S SUGAR RD STE 101
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9140
Mailing Address - Country:US
Mailing Address - Phone:956-388-2700
Mailing Address - Fax:956-388-2710
Practice Address - Street 1:2101 S M ST STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1590
Practice Address - Country:US
Practice Address - Phone:956-317-4044
Practice Address - Fax:956-800-4275
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN4228208M00000X, 2083P0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8GW840OtherBCBS
TX206548405Medicaid
TX2065484-03Medicaid
TX206548406OtherMEDICAID CSHCN
TX8FA610OtherBCBS
TX407274ZX0SOtherMEDICARE
TX407274ZX0SOtherMEDICARE