MEDICARE: DR. AUDREY ELIZABETH AHUERO M.D.

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	207W00000X	Ophthalmology Physician	N8752	TX

General Provider Information

NPI Number	:	1942360516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUDREY ELIZABETH AHUERO M.D.

Provider Business Mailing Address
First Line	:	7500 SAN FELIPE ST
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77063-1707
Country	:	US
Telephone Number	:	713-953-9932
Fax Number	:	713-953-0380

Provider Business Practice Location Address
First Line	:	7500 SAN FELIPE ST
Second Line	:	SUITE 200
City	:	HOUSTON
State	:	TX
Zip	:	77063-1707
Country	:	US
Telephone Number	:	713-953-9932
Fax Number	:	713-953-0380

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	10/02/2012

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