Provider Demographics
NPI:1851860928
Name:KUEO BIRTH CENTER, PLLC
Entity type:Organization
Organization Name:KUEO BIRTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:817-349-7374
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-0128
Mailing Address - Country:US
Mailing Address - Phone:817-349-7374
Mailing Address - Fax:817-984-4266
Practice Address - Street 1:2802 S FM 51 STE B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-4020
Practice Address - Country:US
Practice Address - Phone:817-349-7374
Practice Address - Fax:817-984-4266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing