Healthcare Provider Details

I. General information

NPI: 1164691192
Provider Name (Legal Business Name): CRISTINA V. CUETO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 W WHEATLAND RD
DALLAS TX
75237-3446
US

IV. Provider business mailing address

2050 HALL JOHNSON RD STE 200
GRAPEVINE TX
76051-8766
US

V. Phone/Fax

Practice location:
  • Phone: 972-709-7110
  • Fax: 972-709-7128
Mailing address:
  • Phone: 817-267-2678
  • Fax: 817-354-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberP4748
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: