Provider Demographics
NPI:1922560903
Name:HERRERA VASQUEZ, ALEJANDRO JOSE (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:JOSE
Last Name:HERRERA VASQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 WILLIAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-6232
Mailing Address - Country:US
Mailing Address - Phone:504-471-4860
Mailing Address - Fax:504-930-4218
Practice Address - Street 1:1918 WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-6232
Practice Address - Country:US
Practice Address - Phone:504-471-4860
Practice Address - Fax:504-930-4218
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332889207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine