Healthcare Provider Details

I. General information

NPI: 1235139304
Provider Name (Legal Business Name): ROSA E CUENCA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W 18TH ST STE 101
MT PLEASANT TX
75455-2370
US

IV. Provider business mailing address

301 W 18TH ST STE 101
MT PLEASANT TX
75455-2370
US

V. Phone/Fax

Practice location:
  • Phone: 903-572-9050
  • Fax: 903-572-9051
Mailing address:
  • Phone: 903-572-9050
  • Fax: 903-572-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberM6977
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: