Basic Information
| Provider Information | |||||||||
| NPI: | 1669515185 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUELLAR | ||||||||
| FirstName: | CRISTI | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 203968 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787203968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124671100 | ||||||||
| FaxNumber: | 5124671101 | ||||||||
| Practice Location | |||||||||
| Address1: | 911 W ANDERSON LN | ||||||||
| Address2: | STE 103 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787571501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124671100 | ||||||||
| FaxNumber: | 5124671101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 03/14/2013 | ||||||||
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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 | 225100000X | 1159150 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.