Provider Demographics
NPI:1619307568
Name:FIGUEROA, VICTOR FERNANDO (SA-C)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:FERNANDO
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ROYAL DALTON CIR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-9719
Mailing Address - Country:US
Mailing Address - Phone:936-520-9562
Mailing Address - Fax:832-478-9266
Practice Address - Street 1:17 ROYAL DALTON CIR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-9719
Practice Address - Country:US
Practice Address - Phone:936-520-9562
Practice Address - Fax:832-478-9266
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00499246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00499OtherLICENSE SURGICAL ASSISTANT