Provider Demographics
NPI:1811176787
Name:HECTOR SALCEDO DOVI DO PA
Entity type:Organization
Organization Name:HECTOR SALCEDO DOVI DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALCEDO-DOVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-412-3334
Mailing Address - Street 1:709 CORONADO SOUTH #123
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8847
Mailing Address - Country:US
Mailing Address - Phone:956-412-3334
Mailing Address - Fax:956-412-3350
Practice Address - Street 1:5505 S EXPRESSWAY 77
Practice Address - Street 2:SUITE 300
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3214
Practice Address - Country:US
Practice Address - Phone:956-412-3334
Practice Address - Fax:956-412-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00336YMedicare PIN