Provider Demographics
NPI:1235572413
Name:CUEVAS, THOMAS ALONZO (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALONZO
Last Name:CUEVAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 W PENSACOLA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-1308
Mailing Address - Country:US
Mailing Address - Phone:913-709-9742
Mailing Address - Fax:
Practice Address - Street 1:8249 W 95TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-3200
Practice Address - Country:US
Practice Address - Phone:913-652-6640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.39192207R00000X
KS0419982207R00000X
IL036.144391207R00000X
MIEMC0000088207R00000X
TN60621207R00000X
WA61025513207R00000X
WI623-320207R00000X
MO2014008957207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine