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General NPI Number Information
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NPI Number | 1265829378
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Entity Type | Individual
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Provider Name | CARL CUESTA FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 2110 OAK PARK TRAILS CT
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City | KATY
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State | TX
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Zip | 77450-6023
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Country | US
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Telephone | 281-706-4143
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Fax |
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Provider Business Mailing Address
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Address Line | 3726 AUBURN GROVE CIR
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City | MISSOURI CITY
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State | TX
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Zip | 77459-6807
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Country | US
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Telephone | 281-748-5363
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP126663
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP126663
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License Number State | TX
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