MEDICARE: HUERTA FINE CHIROPRACTIC

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	111N00000X	Chiropractor	12814	TX

General Provider Information

NPI Number	:	1417338120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUERTA FINE CHIROPRACTIC

Provider Business Mailing Address
First Line	:	10622 MONTWOOD DR
Second Line	:	SUITE D
City	:	EL PASO
State	:	TX
Zip	:	79935-2760
Country	:	US
Telephone Number	:	915-599-8695
Fax Number	:	915-599-8672

Provider Business Practice Location Address
First Line	:	10622 MONTWOOD DR
Second Line	:	SUITE D
City	:	EL PASO
State	:	TX
Zip	:	79935-2760
Country	:	US
Telephone Number	:	915-599-8695
Fax Number	:	915-599-8672

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALEJANDRO HUERTA
Credential	:	D.C.
Telephone Number	:	915-599-8695

Provider Enumeration Date	:	06/18/2015
Last Update Date	:	06/18/2015

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