Healthcare Provider Details

I. General information

NPI: 1447249073
Provider Name (Legal Business Name): LUIS M ALBUERNE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 GARTH RD
BAYTOWN TX
77521-2122
US

IV. Provider business mailing address

2190 NORTH LOOP W STE 250
HOUSTON TX
77018-8016
US

V. Phone/Fax

Practice location:
  • Phone: 281-359-7788
  • Fax: 281-359-7888
Mailing address:
  • Phone: 281-359-7788
  • Fax: 281-359-7888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberH1036
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: