MEDICARE: FERMIN CUENCA CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1932513413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FERMIN CUENCA CORPORATION

Provider Business Mailing Address
First Line	:	5447 STILLBROOKE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-5033
Country	:	US
Telephone Number	:	281-727-6971
Fax Number	:	713-728-9673

Provider Business Practice Location Address
First Line	:	5447 STILLBROOKE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-5033
Country	:	US
Telephone Number	:	281-727-6971
Fax Number	:	713-728-9673

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOHN PATRICK CUENCA
Credential	:
Telephone Number	:	281-272-6971

Provider Enumeration Date	:	06/12/2014
Last Update Date	:	06/12/2014

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Directions to “FERMIN CUENCA CORPORATION ” Practice Location

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