Provider Demographics
NPI:1396386439
Name:DE LA GARZA, JOSHUA (RBT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:DE LA GARZA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8004 WEST AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1870
Mailing Address - Country:US
Mailing Address - Phone:210-340-2627
Mailing Address - Fax:
Practice Address - Street 1:8004 WEST AVE STE 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1870
Practice Address - Country:US
Practice Address - Phone:210-340-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-19-93779106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician