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General NPI Number Information
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NPI Number | 1619202728
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Entity Type | Organization
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Legal Business Name | CUELLAR & CUELLAR, P.L.L.C.
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 1284A FARM RD 665
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City | ALICE
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State | TX
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Zip | 78332
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Country | US
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Telephone | 361-779-1156
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Fax |
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Provider Business Mailing Address
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Address Line | 1284A FARM RD 665
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City | ALICE
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State | TX
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Zip | 78332
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Country | US
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Telephone | 361-779-1156
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | RAFAEL CUELLAR JR.
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Credential | PH.D.
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Telephone | 361-779-1156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 33981
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License Number State | TX
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