Provider Demographics
NPI:1750328621
Name:HECTOR H DALESANDRO MD PA
Entity type:Organization
Organization Name:HECTOR H DALESANDRO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAMARILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-930-8200
Mailing Address - Street 1:900 NE LOOP 410 STE D207
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1407
Mailing Address - Country:US
Mailing Address - Phone:210-930-8200
Mailing Address - Fax:210-930-8204
Practice Address - Street 1:900 NE LOOP 410 STE D207
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1407
Practice Address - Country:US
Practice Address - Phone:210-930-8200
Practice Address - Fax:210-930-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMP41102207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W546Medicare PIN