Healthcare Provider Details

I. General information

NPI: 1417700295
Provider Name (Legal Business Name): CARLEEN CUEVAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2024
Last Update Date: 04/10/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 FANNIN ST STE 1400
HOUSTON TX
77030-5389
US

IV. Provider business mailing address

6410 FANNIN ST STE 1400
HOUSTON TX
77030-5389
US

V. Phone/Fax

Practice location:
  • Phone: 832-325-7125
  • Fax: 713-512-2200
Mailing address:
  • Phone: 832-325-7125
  • Fax: 713-512-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: