Healthcare Provider Details

I. General information

NPI: 1255541298
Provider Name (Legal Business Name): HUGO R. HERNANDEZ, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 W HOUSTON ST STE 807
SAN ANTONIO TX
78205-2107
US

IV. Provider business mailing address

343 W HOUSTON ST STE 807
SAN ANTONIO TX
78205-2107
US

V. Phone/Fax

Practice location:
  • Phone: 210-229-1900
  • Fax: 210-229-9890
Mailing address:
  • Phone: 210-229-1900
  • Fax: 210-229-9890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG0428
License Number StateTX

VIII. Authorized Official

Name: DR. HUGO R HERNANDEZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 210-229-1900