Healthcare Provider Details

I. General information

NPI: 1346164068
Provider Name (Legal Business Name): RICARDO CADENA JR. PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 MAGNOLIA PARK ST
SANTA TERESA NM
88008-9587
US

IV. Provider business mailing address

847 MAGNOLIA PARK ST
SANTA TERESA NM
88008-9587
US

V. Phone/Fax

Practice location:
  • Phone: 915-299-2362
  • Fax:
Mailing address:
  • Phone: 915-299-2362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPT-2026-0139
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: