Individual
MR. MICHAEL GERARD FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5656 S STAPLES ST, STE 252, CORPUS CHRISTI, TX 78411-4655
(361) 888-7716
(361) 888-7718
Mailing address
5402 WOOLDRIDGE RD, CORPUS CHRISTI, TX 78413-3837
(361) 888-7716
(361) 888-7718
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
K4062
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030121001
—
TX
Enumeration date
01/04/2007
Last updated
03/05/2014
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