Provider Demographics
NPI:1356398754
Name:HUERTA, ALFREDO JR (MD)
Entity type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:
Last Name:HUERTA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 HIGHWAY 6 N
Mailing Address - Street 2:SUITE #107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1700
Mailing Address - Country:US
Mailing Address - Phone:281-550-0059
Mailing Address - Fax:281-550-0348
Practice Address - Street 1:7825 HWY 6 NORTH
Practice Address - Street 2:#107
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095
Practice Address - Country:US
Practice Address - Phone:281-550-0059
Practice Address - Fax:281-550-0348
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK4709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171828001Medicaid
TX00600WMedicare PIN
TXG97545Medicare UPIN
TX171828001Medicaid