Healthcare Provider Details

I. General information

NPI: 1316682677
Provider Name (Legal Business Name): SYLVIA YVETTE CUEVAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SYLVIA YVETTE CUEVAS PA-C

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 05/02/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17580 INTERSTATE 45 S
THE WOODLANDS TX
77384-4972
US

IV. Provider business mailing address

2509 MONTERREY ST
HIDALGO TX
78557-3581
US

V. Phone/Fax

Practice location:
  • Phone: 936-267-5000
  • Fax:
Mailing address:
  • Phone: 956-451-5123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA15572
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: