Provider Demographics
NPI:1578823209
Name:ATUESTA, ALEXANDER
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:ATUESTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9079 KATY FWY
Mailing Address - Street 2:B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1653
Mailing Address - Country:US
Mailing Address - Phone:713-468-5665
Mailing Address - Fax:713-668-0110
Practice Address - Street 1:9079 KATY FWY
Practice Address - Street 2:B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1653
Practice Address - Country:US
Practice Address - Phone:713-468-5665
Practice Address - Fax:713-668-0110
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician