Provider Demographics
NPI:1649564014
Name:BARREZUETA, HECTOR
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:BARREZUETA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18962
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4084
Mailing Address - Country:US
Mailing Address - Phone:800-566-5050
Mailing Address - Fax:254-537-6401
Practice Address - Street 1:6101 WOODWAY DR
Practice Address - Street 2:SUITE 230
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-6111
Practice Address - Country:US
Practice Address - Phone:254-537-6400
Practice Address - Fax:254-537-6401
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1568208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics