Provider Demographics
NPI:1447055157
Name:CUEVAS SANTOS MOLNAR, JAVIER
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:CUEVAS SANTOS MOLNAR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 CALLAHAN ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-5146
Mailing Address - Country:US
Mailing Address - Phone:918-816-9201
Mailing Address - Fax:
Practice Address - Street 1:823 CALLAHAN ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-5146
Practice Address - Country:US
Practice Address - Phone:918-816-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0121343163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse