Provider Demographics
NPI:1477087039
Name:URESTI, LUIS ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ALBERTO
Last Name:URESTI
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 1:1415 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-2602
Mailing Address - Country:US
Mailing Address - Phone:832-548-5100
Mailing Address - Fax:832-548-5092
Practice Address - Street 1:1415 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2602
Practice Address - Country:US
Practice Address - Phone:832-548-5100
Practice Address - Fax:832-548-5092
Is Sole Proprietor?:No
Enumeration Date:2017-04-20
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8397207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1H8509OtherMEDICARE PTAN