1366576944 NPI number — HECTOR J F BARILLAS P H D P C

Table of content: (NPI 1366576944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366576944 NPI number — HECTOR J F BARILLAS P H D P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HECTOR J F BARILLAS P H D P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366576944
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 N TUCSON BLVD STE 21
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85716-3407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-325-6633
Provider Business Mailing Address Fax Number:
520-325-6677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2102 N COUNTRY CLUB RD
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85716-2831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-325-6633
Provider Business Practice Location Address Fax Number:
520-325-6644
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FERNANDEZ BARILLAS
Authorized Official First Name:
HECTOR
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
520-325-6633

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  1320 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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