Provider Demographics
NPI:1487651527
Name:SAMANIEGO, HECTOR XAVIER JR (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:XAVIER
Last Name:SAMANIEGO
Suffix:JR
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 1:4257 NW LOOP 410
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4710
Mailing Address - Country:US
Mailing Address - Phone:210-732-1773
Mailing Address - Fax:210-732-0991
Practice Address - Street 1:4257 NW LOOP 410
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4710
Practice Address - Country:US
Practice Address - Phone:210-732-1773
Practice Address - Fax:210-732-0991
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH75002084P0804X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114631802Medicaid
TXE20350Medicare UPIN
TX114631802Medicaid