Healthcare Provider Details

I. General information

NPI: 1093995276
Provider Name (Legal Business Name): LAURA HERNANDEZ SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 W SESAME DR
HARLINGEN TX
78550-7930
US

IV. Provider business mailing address

613 W SESAME DR
HARLINGEN TX
78550-7930
US

V. Phone/Fax

Practice location:
  • Phone: 956-399-4500
  • Fax: 956-399-4505
Mailing address:
  • Phone: 956-399-4500
  • Fax: 956-399-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number103477
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: