Provider Demographics
NPI:1619940475
Name:FUENTES, ALEJANDRO (MD)
Entity type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:FUENTES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6646
Mailing Address - Country:US
Mailing Address - Phone:956-969-2536
Mailing Address - Fax:956-968-5542
Practice Address - Street 1:1710 E 8TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6646
Practice Address - Country:US
Practice Address - Phone:956-969-2536
Practice Address - Fax:956-968-5542
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0366207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC15808Medicare UPIN
8F2025Medicare PIN