Provider Demographics
NPI:1992481303
Name:VENZOR-CADENA, RUBY (PTA)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:VENZOR-CADENA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1329
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:KS
Mailing Address - Zip Code:67950-1329
Mailing Address - Country:US
Mailing Address - Phone:580-651-1217
Mailing Address - Fax:
Practice Address - Street 1:2401 NW 23RD ST #2D
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107
Practice Address - Country:US
Practice Address - Phone:405-355-3239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant