Provider Demographics
NPI:1245847649
Name:CERO, REUBEN JAMES OTERO (PT)
Entity type:Individual
Prefix:
First Name:REUBEN JAMES
Middle Name:OTERO
Last Name:CERO
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 1:4035 HIDDEN FORT LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6817
Mailing Address - Country:US
Mailing Address - Phone:346-932-6225
Mailing Address - Fax:
Practice Address - Street 1:2200 FM 1092 RD STE A
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1807
Practice Address - Country:US
Practice Address - Phone:346-932-6225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1337610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist