Provider Demographics
NPI:1760265938
Name:PONCE, HECTOR O (LVN)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:O
Last Name:PONCE
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 N EJIDO AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-1258
Mailing Address - Country:US
Mailing Address - Phone:956-285-5458
Mailing Address - Fax:956-265-3471
Practice Address - Street 1:3515 N EJIDO AVE APT 303
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-1258
Practice Address - Country:US
Practice Address - Phone:956-285-5458
Practice Address - Fax:956-265-3471
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)