Basic Information
Provider Information
NPI: 1992236863
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALAGUERA CUERVO
FirstName: PEDRO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7200 CAMBRIDGE ST
Address2: 9TH FLOOR
City: HOUSTON
State: TX
PostalCode: 770304202
CountryCode: US
TelephoneNumber: 7137986151
FaxNumber:  
Practice Location
Address1: 6410 FANNIN ST STE 1014
Address2:  
City: HOUSTON
State: TX
PostalCode: 770305301
CountryCode: US
TelephoneNumber: 8323257080
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/22/2017
LastUpdateDate: 08/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2084N0400XT8479TXY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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