Provider Demographics
NPI:1710646229
Name:RUBIO, JOSE GILBERTO JR (BCBA)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:GILBERTO
Last Name:RUBIO
Suffix:JR
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N ESPLANADE ST
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-8127
Mailing Address - Country:US
Mailing Address - Phone:903-245-5881
Mailing Address - Fax:
Practice Address - Street 1:707 N ESPLANADE ST
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-8127
Practice Address - Country:US
Practice Address - Phone:903-245-5881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-12
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4250103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst