MEDICARE: ALFREDO HUERTA JR. MD PA

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

General Provider Information

NPI Number	:	1740336205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFREDO HUERTA JR. MD PA

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

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

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALFREDO HUERTA HUERTA JR.
Credential	:	M.D.
Telephone Number	:	281-550-0059

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	02/25/2008

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