Provider Demographics
NPI:1093431421
Name:RUBALCAVA, DIEGO ESTEVANE (LPC)
Entity Type:Individual
Prefix:
First Name:DIEGO
Middle Name:ESTEVANE
Last Name:RUBALCAVA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 OAKMIST BEND LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4505
Mailing Address - Country:US
Mailing Address - Phone:832-296-9539
Mailing Address - Fax:
Practice Address - Street 1:15101 EAST FWY
Practice Address - Street 2:
Practice Address - City:CHANNELVIEW
Practice Address - State:TX
Practice Address - Zip Code:77530-4104
Practice Address - Country:US
Practice Address - Phone:832-844-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80687101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional