| Doctor Name: | DR. LUIS FUENTES |
| NPI Number: | 1487030417 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | BP10053714 |
| Business Practice Address: | 4818 Holly Rd Ste A Corpus Christi, TX - 784114734 |
| Business Phone Number: | 3619931747 |
| Business Fax Number: | 3619931748 |
| Mailing Address: | 1641 Nile Dr Apt 422, CORPUS CHRISTI |
| State: | TX |
| Postal Code: | 784124965 |
| Phone Number: | 9562365477 |
| Fax Number: | |
| NPI Enumeration Date: | 07/31/2015 |
| NPI Last Update Date: | 07/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | BP10053714 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |