Provider Demographics
NPI:1548269210
Name:OCARANZA, HECTOR IGNACIO (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:IGNACIO
Last Name:OCARANZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4530
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:TX
Mailing Address - Zip Code:79821-0047
Mailing Address - Country:US
Mailing Address - Phone:575-882-2956
Mailing Address - Fax:575-882-1863
Practice Address - Street 1:1265 ANTHONY DR.
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:NM
Practice Address - Zip Code:88021
Practice Address - Country:US
Practice Address - Phone:575-882-2956
Practice Address - Fax:575-882-1863
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM98-357208000000X
TXK8807208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM75654Medicaid
NMH31257Medicare UPIN