Provider Demographics
NPI:1780674762
Name:CABALLERO, HECTOR (MD)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:
Last Name:CABALLERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 1ST ST N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8706
Mailing Address - Country:US
Mailing Address - Phone:205-620-9187
Mailing Address - Fax:205-620-9189
Practice Address - Street 1:1022 1ST ST N
Practice Address - Street 2:SUITE 300
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8725
Practice Address - Country:US
Practice Address - Phone:205-620-9187
Practice Address - Fax:205-620-9189
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25521174400000X
TNMD388152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3325511Medicare ID - Type Unspecified
TNH97882Medicare UPIN