Provider Demographics
NPI:1124142369
Name:ESTEPAN, HECTOR (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:
Last Name:ESTEPAN
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 319
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28661-0319
Mailing Address - Country:US
Mailing Address - Phone:828-754-6850
Mailing Address - Fax:828-757-3214
Practice Address - Street 1:1345 NC HIGHWAY 268
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-9027
Practice Address - Country:US
Practice Address - Phone:828-754-6850
Practice Address - Fax:828-757-3214
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1310531208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00131053Medicaid
NYAE8736057OtherDEA