Provider Demographics
NPI:1659569507
Name:PEGUERO, JULIO ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:ANTONIO
Last Name:PEGUERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:902 FROSTWOOD DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2420
Mailing Address - Country:US
Mailing Address - Phone:713-800-0656
Mailing Address - Fax:713-827-1380
Practice Address - Street 1:925 GESSNER RD
Practice Address - Street 2:SUITE 600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2545
Practice Address - Country:US
Practice Address - Phone:713-827-9525
Practice Address - Fax:713-468-3561
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2013-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10029706207R00000X
TXN7570207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology