Provider Demographics
NPI:1902857238
Name:FENTON, HUBERT HENRY (MD)
Entity type:Individual
Prefix:
First Name:HUBERT
Middle Name:HENRY
Last Name:FENTON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11331 JAMES WATT DR STE 300A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6401
Mailing Address - Country:US
Mailing Address - Phone:303-946-6892
Mailing Address - Fax:
Practice Address - Street 1:11331 JAMES WATT DR STE 300A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6401
Practice Address - Country:US
Practice Address - Phone:303-946-6892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT2367207ZP0102X
SC81727207ZP0102X
MDD64050207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT2367OtherMEDICAL LICENSE
SC81727OtherMEDICAL LICENSE