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NPI Code Detail

MEDICARE: TIMOTHY ROLANDO JUAREZ

MEDICARE: TIMOTHY ROLANDO JUAREZ
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
1106S00000XBehavior TechnicianTX

General Provider Information

NPI Number : 1871420661
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY ROLANDO JUAREZ
Provider Business Mailing Address
First Line : 122 OAKWOOD DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228-3811
Country : US
Telephone Number : 210-438-4349
Fax Number :
Provider Business Practice Location Address
First Line : 122 OAKWOOD DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78228-3811
Country : US
Telephone Number : 210-438-4349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2026
Last Update Date : 05/06/2026

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Directions to “ TIMOTHY ROLANDO JUAREZ ” Practice Location

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