Provider Demographics
NPI:1194325118
Name:ESPARZA, HECTOR GUILLERMO JR
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:GUILLERMO
Last Name:ESPARZA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9461 WEBB CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-4958
Mailing Address - Country:US
Mailing Address - Phone:214-530-5451
Mailing Address - Fax:214-530-0324
Practice Address - Street 1:9461 WEBB CHAPEL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4958
Practice Address - Country:US
Practice Address - Phone:214-530-5451
Practice Address - Fax:214-530-0324
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist