Provider Demographics
NPI:1285843490
Name:FIDEL G HUERTA JR. INC.
Entity Type:Organization
Organization Name:FIDEL G HUERTA JR. INC.
Other - Org Name:HEALTH PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARPEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:210-433-5400
Mailing Address - Street 1:4006 NOGALITOS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-1300
Mailing Address - Country:US
Mailing Address - Phone:210-924-5163
Mailing Address - Fax:210-924-3122
Practice Address - Street 1:4006 NOGALITOS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-1300
Practice Address - Country:US
Practice Address - Phone:210-924-5163
Practice Address - Fax:210-924-3122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14577332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1164890007Medicare ID - Type UnspecifiedMEDICARE IDENTIFIER