MEDICARE: PT CUENCA LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1417396052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PT CUENCA LLC

Provider Business Mailing Address
First Line	:	5447 STILLBROOKE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-5033
Country	:	US
Telephone Number	:	713-728-9673
Fax Number	:

Provider Business Practice Location Address
First Line	:	5447 STILLBROOKE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-5033
Country	:	US
Telephone Number	:	713-728-9673
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. PATRICK J CUENCA
Credential	:
Telephone Number	:	281-727-6971

Provider Enumeration Date	:	06/17/2013
Last Update Date	:	06/17/2013

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Directions to “PT CUENCA LLC ” Practice Location

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