Provider Demographics
NPI:1942844972
Name:CUELLAR, SHELBY (DC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:CUELLAR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 RUBY RD
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-3753
Mailing Address - Country:US
Mailing Address - Phone:513-607-0333
Mailing Address - Fax:
Practice Address - Street 1:2051 CENTENNIAL BOULEVARD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KY
Practice Address - Zip Code:41051
Practice Address - Country:US
Practice Address - Phone:859-727-6888
Practice Address - Fax:859-727-6878
Is Sole Proprietor?:No
Enumeration Date:2019-11-02
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY260595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor