Provider Demographics
NPI:1487663324
Name:DE LA CRUZ, HECTOR JR (DC)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:
Last Name:DE LA CRUZ
Suffix:JR
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 1:5327 S MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9168
Mailing Address - Country:US
Mailing Address - Phone:956-631-2277
Mailing Address - Fax:956-631-2256
Practice Address - Street 1:5327 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9168
Practice Address - Country:US
Practice Address - Phone:956-631-2277
Practice Address - Fax:956-631-2256
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7397111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609023Medicare ID - Type Unspecified
TXU75020Medicare UPIN