Individual
MICHAEL FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.T
Contact information
Practice address
117-B LOUIS HENNA BLVD, STE. 200, ROUND ROCK, TX 78664
(512) 255-9634
Mailing address
10001 S 1ST ST, APT 328, AUSTIN, TX 78748-6686
(210) 601-2349
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
1268326
TX
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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