Provider Demographics
NPI:1821575036
Name:ARIAS FUENMAYOR, EURO DE JESUS (SA-C)
Entity Type:Individual
Prefix:
First Name:EURO DE
Middle Name:JESUS
Last Name:ARIAS FUENMAYOR
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 FALCON PARK DR APT 12103
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5203
Mailing Address - Country:US
Mailing Address - Phone:979-730-9563
Mailing Address - Fax:
Practice Address - Street 1:1111 FALCON PARK DR APT 12103
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5203
Practice Address - Country:US
Practice Address - Phone:979-730-9563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18-325246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant