MEDICARE: MR. HERMES DANIEL HERNANDEZ ALFONSO SR. FNP-C

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	363LF0000X	Family Nurse Practitioner	352952	NY
2	163WA2000X	Administrator Registered Nurse	1022089	TX
3	163WG0000X	General Practice Registered Nurse	787482	NY
4	363LF0000X	Family Nurse Practitioner	30492	SC
5	363LF0000X	Family Nurse Practitioner	1022089	TX
6	246ZC0007X	Surgical Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1760104616	OTHER	TX	PRIVATE INSURANCE

General Provider Information

NPI Number	:	1528457827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HERMES DANIEL HERNANDEZ ALFONSO SR. FNP-C

Provider Business Mailing Address
First Line	:	23441 YAUPON HILLS DR
Second Line	:
City	:	NEW CANEY
State	:	TX
Zip	:	77357-3867
Country	:	US
Telephone Number	:	772-584-5543
Fax Number	:	713-492-2718

Provider Business Practice Location Address
First Line	:	96 BERRY RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77022-3057
Country	:	US
Telephone Number	:	713-492-2661
Fax Number	:	713-492-2718

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

Provider Enumeration Date	:	01/10/2015
Last Update Date	:	02/08/2026

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