Provider Demographics
NPI:1205865391
Name:BARRERA, ALFONSO (MD, FACS)
Entity Type:Individual
Prefix:
First Name:ALFONSO
Middle Name:
Last Name:BARRERA
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 GESSNER RD
Mailing Address - Street 2:SUITE 825
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2527
Mailing Address - Country:US
Mailing Address - Phone:713-468-5200
Mailing Address - Fax:713-468-8564
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 825
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-468-5200
Practice Address - Fax:713-468-8564
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3037174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC13204Medicare ID - Type Unspecified