Provider Demographics
NPI:1164571956
Name:MOTA, ESTUARDO ALFREDO (LSA)
Entity Type:Individual
Prefix:MR
First Name:ESTUARDO
Middle Name:ALFREDO
Last Name:MOTA
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1111 OLD OYSTER TRL
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4537
Mailing Address - Country:US
Mailing Address - Phone:832-637-7127
Mailing Address - Fax:713-583-3047
Practice Address - Street 1:1111 OLD OYSTER TRL
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4537
Practice Address - Country:US
Practice Address - Phone:832-646-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2019-01-10
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical