Provider Demographics
NPI:1487862785
Name:HECTOR F COLON, MD, PA
Entity type:Organization
Organization Name:HECTOR F COLON, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:F
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-526-2343
Mailing Address - Street 1:PO BOX 1658
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78296-1658
Mailing Address - Country:US
Mailing Address - Phone:254-526-2343
Mailing Address - Fax:254-526-1084
Practice Address - Street 1:2207 S CLEAR CREEK RD STE 205
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4133
Practice Address - Country:US
Practice Address - Phone:254-526-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ89672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX036025701Medicaid
TXG06084Medicare UPIN
TX00Z811Medicare PIN