MEDICARE: RAFAEL DE LEON JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-25-416548	TX

General Provider Information

NPI Number	:	1619800901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL DE LEON JR.

Provider Business Mailing Address
First Line	:	2202 CORNERSTONE BLVD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-0907
Country	:	US
Telephone Number	:	956-884-4944
Fax Number	:

Provider Business Practice Location Address
First Line	:	2202 CORNERSTONE BLVD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-0907
Country	:	US
Telephone Number	:	956-884-4944
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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Directions to “ RAFAEL DE LEON JR. ” Practice Location

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