Provider Demographics
NPI:1578879680
Name:HECTOR L NEVAREZ MD PA
Entity Type:Organization
Organization Name:HECTOR L NEVAREZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OPHTHALMOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:NEVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:210-224-6633
Mailing Address - Street 1:730 N MAIN AVE
Mailing Address - Street 2:SUITE 418
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1152
Mailing Address - Country:US
Mailing Address - Phone:210-224-6633
Mailing Address - Fax:210-224-0416
Practice Address - Street 1:730 N MAIN AVE
Practice Address - Street 2:SUITE 418
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1152
Practice Address - Country:US
Practice Address - Phone:210-224-6633
Practice Address - Fax:210-224-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty