Active NPI
Hector Astudillo Mantilla, LSA
- Surgery Physician
- Tomball, TX
National Provider Identifier
1164845236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- SA00561
- Practice address
- 18006 Islet CT
Tomball, TX 77377-2378 - Phone
- (281) 653-2924
- Fax
- (832) 478-9266
- NPI assigned
- Jan 27, 2014
- Last updated
- Dec 1, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | SA00561 | TX | Primary |
Addresses
Primary practice location
18006 Islet CT
Tomball, TX 77377-2378
Mailing address
18006 Islet CT
Tomball, TX 77377-2378
Phone (281) 653-2924
Other practice location 1
8203 Willow Place Dr S
Suite 419
Houston, TX 77070-5655
Phone (832) 237-5667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA00561 | TX | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Astudillo Surgical Assistant LLC | Current | Accepting new patients | |
| Houston Surgical Assistant Services | Surgery | Past | Accepting new patients |
| Houston Surgical Assistant Services, Inc. | Surgery | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Surgical Assistant
- Tomball, TX
- NPI 1760087431
-
- Surgery Physician
- Houston, TX
- NPI 1184703902
-
- Surgical Physician Assistant
- Houston, TX
- NPI 1861758609
Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1164845236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18006 ISLET CT",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773772378",
"telephone_number": "281-653-2924",
"fax_number": "832-478-9266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18006 ISLET CT",
"city": "TOMBALL",
"state": "TX",
"postal_code": "773772378",
"telephone_number": "281-653-2924",
"fax_number": "832-478-9266"
}
],
"practiceLocations": [
{
"address_1": "8203 Willow Place Dr S",
"address_2": "Suite 419",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770705655",
"country_code": "US",
"telephone_number": "832-237-5667",
"fax_number": "832-237-5655",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ASTUDILLO MANTILLA",
"first_name": "HECTOR",
"credential": "LSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-27",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "SA00561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tomball, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.