MEDICARE: HECTOR HUGO VASQUEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	E9449	TX

General Provider Information

NPI Number	:	1518075894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HECTOR HUGO VASQUEZ M.D.

Provider Business Mailing Address
First Line	:	3066 E COMMERCE ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78220-1013
Country	:	US
Telephone Number	:	210-233-7000
Fax Number	:	210-277-6387

Provider Business Practice Location Address
First Line	:	1340 WONDER WORLD DR
Second Line	:	STE. 4201
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-7598
Country	:	US
Telephone Number	:	512-268-8900
Fax Number	:	512-392-2567

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	12/02/2016

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