Healthcare Provider Details

I. General information

NPI: 1538616867
Provider Name (Legal Business Name): CHEREE DENISE CUELLAR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2016
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N WASHINGTON AVE STE 6000
DALLAS TX
75246-1789
US

IV. Provider business mailing address

1505 LBJ FWY STE 700
DALLAS TX
75234-6065
US

V. Phone/Fax

Practice location:
  • Phone: 214-358-2300
  • Fax: 214-579-6988
Mailing address:
  • Phone: 214-358-2300
  • Fax: 214-579-6941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP13188
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: