Provider Demographics
NPI:1073641650
Name:MESTRES, HUGH (MD)
Entity Type:Individual
Prefix:
First Name:HUGH
Middle Name:
Last Name:MESTRES
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 1:1038 ARBOR POINTE DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63088-1458
Mailing Address - Country:US
Mailing Address - Phone:636-225-4680
Mailing Address - Fax:
Practice Address - Street 1:1038 ARBOR POINTE DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63088-1458
Practice Address - Country:US
Practice Address - Phone:636-225-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO25930171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider