Provider Demographics
NPI:1083076228
Name:TOLEDO ATUCHA, JUAN BAUTISTA (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:BAUTISTA
Last Name:TOLEDO ATUCHA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:JON
Other - Middle Name:B
Other - Last Name:TOLEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:6560 FANNIN ST STE 750
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2727
Mailing Address - Country:US
Mailing Address - Phone:713-441-3780
Mailing Address - Fax:
Practice Address - Street 1:6560 FANNIN ST STE 750
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2727
Practice Address - Country:US
Practice Address - Phone:713-441-3780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-27
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT70612084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology