Healthcare Provider Details

I. General information

NPI: 1578558987
Provider Name (Legal Business Name): DAVID ALPHONSO HECTOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 S FLEISHEL AVE SUITE 101
TYLER TX
75701-2004
US

IV. Provider business mailing address

619 S FLEISHEL AVE SUITE 101
TYLER TX
75701-2004
US

V. Phone/Fax

Practice location:
  • Phone: 903-595-5514
  • Fax:
Mailing address:
  • Phone: 903-595-5514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG1914
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG1914
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: