Provider Demographics
NPI:1912151218
Name:CUELLAR, RAFAEL JR (PHD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:CUELLAR
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 A FM RD 665
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332
Mailing Address - Country:US
Mailing Address - Phone:361-779-1156
Mailing Address - Fax:361-664-2027
Practice Address - Street 1:1284 A FM RD 665
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332
Practice Address - Country:US
Practice Address - Phone:361-779-1156
Practice Address - Fax:361-664-2027
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33981103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling