Provider Demographics
NPI:1871354639
Name:CUEVAS, CAMERON REY
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:REY
Last Name:CUEVAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1178
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:TX
Mailing Address - Zip Code:78593-1178
Mailing Address - Country:US
Mailing Address - Phone:956-793-4614
Mailing Address - Fax:
Practice Address - Street 1:217 SANTA VISTA AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:TX
Practice Address - Zip Code:78593-2446
Practice Address - Country:US
Practice Address - Phone:956-793-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician