Provider Demographics
NPI:1710968714
Name:CUELLAR, ALBERTO D (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:D
Last Name:CUELLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALBERT
Other - Middle Name:D
Other - Last Name:CUELLAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4356
Mailing Address - Street 2:DEPT 665
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4356
Mailing Address - Country:US
Mailing Address - Phone:281-440-6960
Mailing Address - Fax:281-440-6205
Practice Address - Street 1:17270 RED OAK DR
Practice Address - Street 2:STE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2632
Practice Address - Country:US
Practice Address - Phone:281-440-6960
Practice Address - Fax:281-440-6205
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG88816207X00000X
TXG8816207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129382101Medicaid
TXG8816OtherSTATE LICENSE
TXA0061943OtherDPS
TXA0061943OtherDPS
TX129382101Medicaid
TXA0061943OtherDPS