Provider Demographics
NPI:1295094712
Name:CUALOPING, KHANYA FLOR MANATRAKOOL (MD)
Entity type:Individual
Prefix:DR
First Name:KHANYA FLOR
Middle Name:MANATRAKOOL
Last Name:CUALOPING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1919 ALAMEDA DE LAS PULGAS
Mailing Address - Street 2:APT 80
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1266
Mailing Address - Country:US
Mailing Address - Phone:650-312-1825
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:STOP 8143
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX566030207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine