Provider Demographics
NPI:1740522572
Name:CARDENAS, RUBEN (RPH)
Entity type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:
Last Name:CARDENAS
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 1:201 FAR HILLS DR
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-2105
Mailing Address - Country:US
Mailing Address - Phone:830-774-6774
Mailing Address - Fax:
Practice Address - Street 1:200 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4658
Practice Address - Country:US
Practice Address - Phone:830-774-4579
Practice Address - Fax:830-774-3946
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist