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General NPI Number Information
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NPI Number | 1699936286
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Entity Type | Individual
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Provider Name | ENRIQUE ATUESTA OPTICIAN
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Gender | Male
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 5739 BELLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77081-5505
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Country | US
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Telephone | 713-668-1307
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Fax | 713-668-0110
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Provider Business Mailing Address
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Address Line | 5739 BELLAIRE BLVD
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City | HOUSTON
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State | TX
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Zip | 77081-5505
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Country | US
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Telephone | 713-668-1307
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Fax | 713-668-0110
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | DR0773
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License Number State | TX
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