MEDICARE: VALERIE CHRISTY HERNANDEZ

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer		TX

General Provider Information

NPI Number	:	1205412210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE CHRISTY HERNANDEZ

Provider Business Mailing Address
First Line	:	4034 MOUNT LAUREL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1024
Country	:	US
Telephone Number	:	210-843-7070
Fax Number	:

Provider Business Practice Location Address
First Line	:	4034 MOUNT LAUREL DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1024
Country	:	US
Telephone Number	:	210-843-7070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2021
Last Update Date	:	09/01/2023

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