Provider Demographics
NPI:1609674407
Name:CUELLAR, BRIANNA NICOLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:NICOLE
Last Name:CUELLAR
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:NICOLE
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:434 SHADYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6814
Mailing Address - Country:US
Mailing Address - Phone:956-393-0812
Mailing Address - Fax:
Practice Address - Street 1:730 N MAIN AVE STE 107
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1115
Practice Address - Country:US
Practice Address - Phone:210-297-7725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1348637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist