Healthcare Provider Details

I. General information

NPI: 1609083419
Provider Name (Legal Business Name): RON V CUEVAS OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VALLEY RIVER CTR
EUGENE OR
97401-2124
US

IV. Provider business mailing address

400 VALLEY RIVER CTR
EUGENE OR
97401-2124
US

V. Phone/Fax

Practice location:
  • Phone: 541-687-8666
  • Fax: 541-302-1951
Mailing address:
  • Phone: 541-687-8666
  • Fax: 541-302-1951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberOR1824T
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. RONALD V CUEVAS
Title or Position: OWNER
Credential: O.D.
Phone: 541-687-8666