Healthcare Provider Details

I. General information

NPI: 1124406061
Provider Name (Legal Business Name): CUAN CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2015
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2665 VILLA CREEK DR SUITE 252
DALLAS TX
75234-7309
US

IV. Provider business mailing address

2665 VILLA CREEK DR SUITE 252
DALLAS TX
75234-7309
US

V. Phone/Fax

Practice location:
  • Phone: 972-422-9993
  • Fax: 972-994-0253
Mailing address:
  • Phone: 972-422-9993
  • Fax: 972-994-0253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NIEVA CUA
Title or Position: DIRECTOR
Credential: RN
Phone: 972-422-9993