Healthcare Provider Details

I. General information

NPI: 1427946011
Provider Name (Legal Business Name): ANA NAYETZI DE CUESTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12615 LAS MAJADAS RANCH RD
RAYMONVILLE TX
78580
US

IV. Provider business mailing address

149 CAMEO DR
SAN BENITO TX
78586-0193
US

V. Phone/Fax

Practice location:
  • Phone: 956-742-8545
  • Fax:
Mailing address:
  • Phone: 956-752-8545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number1053448
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: