Healthcare Provider Details

I. General information

NPI: 1972328482
Provider Name (Legal Business Name): MARTHA CYNTHIA CUEVAS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6620 MAIN ST STE H1300
HOUSTON TX
77030-2348
US

IV. Provider business mailing address

7106 DEEP FOREST DR
HOUSTON TX
77088-6623
US

V. Phone/Fax

Practice location:
  • Phone: 713-797-1144
  • Fax: 713-797-0556
Mailing address:
  • Phone: 281-919-6212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1179115
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: