Provider Demographics
NPI:1285742056
Name:HIGUCHI, JUNJI HENRY (MD)
Entity type:Individual
Prefix:
First Name:JUNJI
Middle Name:HENRY
Last Name:HIGUCHI
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 1:1200 BROOKLYN AVE
Mailing Address - Street 2:STE 380
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4815
Mailing Address - Country:US
Mailing Address - Phone:210-225-2341
Mailing Address - Fax:210-225-4403
Practice Address - Street 1:1200 BROOKLYN AVE STE 380
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4815
Practice Address - Country:US
Practice Address - Phone:210-225-2341
Practice Address - Fax:210-225-4403
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6810207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113936202Medicaid
80160NMedicare ID - Type Unspecified