Healthcare Provider Details

I. General information

NPI: 1164957528
Provider Name (Legal Business Name): RAMON CUENCAS-ZAMORA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 MAPLE AVE SUITE 100
DALLAS TX
75235-6519
US

IV. Provider business mailing address

5701 MAPLE AVE SUITE 100
DALLAS TX
75235-6519
US

V. Phone/Fax

Practice location:
  • Phone: 214-351-6600
  • Fax: 214-351-6453
Mailing address:
  • Phone: 214-351-6600
  • Fax: 214-351-6453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15175
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: