MEDICARE: DAVID CHARLES CUELLAR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	L6335	TX

General Provider Information

NPI Number	:	1376519330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CHARLES CUELLAR MD

Provider Business Mailing Address
First Line	:	8240 N MOPAC EXPY STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8869
Country	:	US
Telephone Number	:	512-687-1950
Fax Number	:	512-407-9010

Provider Business Practice Location Address
First Line	:	16040 PARK VALLEY DR STE 111
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-3596
Country	:	US
Telephone Number	:	512-248-2200
Fax Number	:	512-248-1950

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	09/14/2021

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Directions to “ DAVID CHARLES CUELLAR MD” Practice Location

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