Provider Demographics
NPI:1730912924
Name:VILLALOBOS, JOSELUIS ALEXANDRE (RBT)
Entity type:Individual
Prefix:MR
First Name:JOSELUIS
Middle Name:ALEXANDRE
Last Name:VILLALOBOS
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 1:1600 S LAKELINE BLVD APT 1625
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2025
Mailing Address - Country:US
Mailing Address - Phone:512-277-9928
Mailing Address - Fax:
Practice Address - Street 1:4003 W STAN SCHLUETER LOOP
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-6119
Practice Address - Country:US
Practice Address - Phone:254-630-1578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-23-305312106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician