Provider Demographics
NPI:1881275121
Name:CUEVAS, ROBERTO DANIEL
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:DANIEL
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 1:800 NE 10TH ST STE 3029
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5418
Mailing Address - Country:US
Mailing Address - Phone:405-271-8778
Mailing Address - Fax:405-271-3468
Practice Address - Street 1:800 NE 10TH ST STE 3029
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5418
Practice Address - Country:US
Practice Address - Phone:405-271-8778
Practice Address - Fax:405-271-3468
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKT-26673183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician