Provider Demographics
NPI:1902102056
Name:HECTOR X. SAMANIEGO, JR., M.D., P.A.
Entity Type:Organization
Organization Name:HECTOR X. SAMANIEGO, JR., M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:SAMANIEGO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:210-732-1773
Mailing Address - Street 1:4257 NW LOOP 410
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4710
Mailing Address - Country:US
Mailing Address - Phone:210-732-1773
Mailing Address - Fax:210-732-0991
Practice Address - Street 1:4257 NW LOOP 410
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4710
Practice Address - Country:US
Practice Address - Phone:210-732-1773
Practice Address - Fax:210-732-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7500103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty