Provider Demographics
NPI:1922248061
Name:CUELLAR, DEBRA ANN (PT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:CUELLAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:EASTERLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:21200 HWY 46 W
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6793
Mailing Address - Country:US
Mailing Address - Phone:830-980-4055
Mailing Address - Fax:830-438-4085
Practice Address - Street 1:21200 HWY 46 W
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6793
Practice Address - Country:US
Practice Address - Phone:830-980-4055
Practice Address - Fax:830-438-4085
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1075679225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist