Healthcare Provider Details

I. General information

NPI: 1649071838
Provider Name (Legal Business Name): RIGOBERTO HERNANDEZ PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MCGREGOR RANGE RD
CHAPARRAL NM
88081-7753
US

IV. Provider business mailing address

PO BOX 12076
EL PASO TX
79913-0076
US

V. Phone/Fax

Practice location:
  • Phone: 575-824-4884
  • Fax: 575-824-5271
Mailing address:
  • Phone: 915-841-8505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1192511
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number83328
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: