Provider Demographics
NPI:1750751814
Name:CREECH, CUYLER
Entity type:Individual
Prefix:
First Name:CUYLER
Middle Name:
Last Name:CREECH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-1956
Mailing Address - Country:US
Mailing Address - Phone:682-205-3340
Mailing Address - Fax:682-205-3342
Practice Address - Street 1:300 S MORGAN ST
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-1956
Practice Address - Country:US
Practice Address - Phone:682-205-3340
Practice Address - Fax:682-205-3342
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213509224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant