Provider Demographics
NPI:1124162276
Name:VAZQUEZ, ALFREDO J (DC)
Entity type:Individual
Prefix:
First Name:ALFREDO
Middle Name:J
Last Name:VAZQUEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 GULF FWY S STE B
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6769
Mailing Address - Country:US
Mailing Address - Phone:832-647-0761
Mailing Address - Fax:281-282-9711
Practice Address - Street 1:103 DAVIS RD STE A
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2769
Practice Address - Country:US
Practice Address - Phone:832-647-0761
Practice Address - Fax:713-481-6229
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10532111NR0400X, 111NX0100X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NX0100XChiropractic ProvidersChiropractorOccupational Health