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NPI Code Detail

MEDICARE: JAVIER HERNANDEZ LMT

MEDICARE: JAVIER HERNANDEZ LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMT135347TX

General Provider Information

NPI Number : 1184396764
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAVIER HERNANDEZ LMT
Provider Business Mailing Address
First Line : 1001 12TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3926
Country : US
Telephone Number : 817-719-7714
Fax Number :
Provider Business Practice Location Address
First Line : 1001 12TH AVE STE 201
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3946
Country : US
Telephone Number : 817-719-7714
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2021
Last Update Date : 08/29/2023

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Directions to “ JAVIER HERNANDEZ LMT” Practice Location

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