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General NPI Number Information
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NPI Number | 1598376394
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Entity Type | Individual
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Provider Name | ALEC GERARD CUELLO PA
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Gender | Male
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Dates
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Enumeration Date | 08/14/2020
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 3600 N GARFIELD ST
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City | MIDLAND
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State | TX
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Zip | 79705-6329
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Country | US
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Telephone | 210-219-2431
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Fax |
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Provider Business Mailing Address
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Address Line | 415 S MESA HILLS DR APT 1317
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City | EL PASO
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State | TX
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Zip | 79912-5483
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Country | US
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Telephone | 210-219-2431
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA15150
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License Number State | TX
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