| Doctor Name: | DR. HECTOR IVAN BURGOS |
| NPI Number: | 1609852490 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 9942 |
| Business Practice Address: | Highway 18 East Pine Ridge Hospital - Indian Health Service Unit Pine Ridge, SD - 57770 |
| Business Phone Number: | 6058673273 |
| Business Fax Number: | 6058673271 |
| Mailing Address: | Po Box 1201, Pine Ridge Indian Health Service Unit PINE RIDGE |
| State: | SD |
| Postal Code: | 577701201 |
| Phone Number: | 6058673273 |
| Fax Number: | 6058673271 |
| NPI Enumeration Date: | 12/22/2005 |
| NPI Last Update Date: | 01/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 9942 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |