Healthcare Provider Details

I. General information

NPI: 1346345147
Provider Name (Legal Business Name): RACHEL ANNE CUENCA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N SANTA ROSA STE 900
SAN ANTONIO TX
78207-3108
US

IV. Provider business mailing address

3551 ROGER BROOKE DR
SAN ANTONIO TX
78234-4504
US

V. Phone/Fax

Practice location:
  • Phone: 210-704-3030
  • Fax:
Mailing address:
  • Phone: 202-361-2199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberD65073
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberV3578
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: