MEDICARE: DR. ALFREDO HUERTA JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	K4709	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356398754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFREDO HUERTA JR. MD

Provider Business Mailing Address
First Line	:	7825 HIGHWAY 6 N
Second Line	:	SUITE #107
City	:	HOUSTON
State	:	TX
Zip	:	77095-1700
Country	:	US
Telephone Number	:	281-550-0059
Fax Number	:	281-550-0348

Provider Business Practice Location Address
First Line	:	7825 HWY 6 NORTH
Second Line	:	#107
City	:	HOUSTON
State	:	TX
Zip	:	77095
Country	:	US
Telephone Number	:	281-550-0059
Fax Number	:	281-550-0348

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	06/20/2011

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