Provider Demographics
NPI:1134424849
Name:ALONSO, VICTOR JONATHAN III (PHD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JONATHAN
Last Name:ALONSO
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:450 NORTH SAM HOUSTON PARKWAY
Mailing Address - Street 2:SUITE156
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2910
Mailing Address - Country:US
Mailing Address - Phone:713-261-2950
Mailing Address - Fax:
Practice Address - Street 1:450 N SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 156
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3551
Practice Address - Country:US
Practice Address - Phone:713-261-2950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEG
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program