Healthcare Provider Details

I. General information

NPI: 1922007012
Provider Name (Legal Business Name): HECTOR M. CABRERA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 GENERAL DE GAULLE DR
NEW ORLEANS LA
70114-8207
US

IV. Provider business mailing address

3801 GENERAL DE GAULLE DR
NEW ORLEANS LA
70114-8207
US

V. Phone/Fax

Practice location:
  • Phone: 504-362-2829
  • Fax: 504-362-2866
Mailing address:
  • Phone: 504-362-2829
  • Fax: 504-362-2866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13819R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: