Basic Information
| Provider Information | |||||||||
| NPI: | 1366735375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUEVAS | ||||||||
| FirstName: | CHRISTEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 920 STANTON L YOUNG BLVD # WP3010 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731045036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052714742 | ||||||||
| FaxNumber: | 4052712619 | ||||||||
| Practice Location | |||||||||
| Address1: | 1202 3RD ST | ||||||||
| Address2: | |||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784042314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3616540617 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2011 | ||||||||
| LastUpdateDate: | 02/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | R9479 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | BP1-0040888 | 01 | TX | PERMIT NUMBER | OTHER |