Fuentevilla, Ana

Fuentevilla, Ana is an individual health care provider with primary practice located at 2500 W William Cannon Dr Ste 205 , Austin TX 78745-5288. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Fuentevilla, Ana can be contacted via phone (512) 548-0465.

Contact Information

Primary practice address
2500 W William Cannon Dr Ste 205 Austin TX 78745-5288
Phone: (512) 548-0465
Fax: (737) 707-3908
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X T9687 Texas
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 18893 Arizona

Profile Details

NPI number 1679554430
LBN Legal business name Fuentevilla, Ana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Dec 8th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679554430 NPPES
Arizona MEDICAID 110643

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