Healthcare Provider Details

I. General information

NPI: 1306776703
Provider Name (Legal Business Name): HANY MANUDIS HERNANDEZ BERNAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21503 RAINFALL PARK DR
SPRING TX
77388-2645
US

IV. Provider business mailing address

21503 RAINFALL PARK DR
SPRING TX
77388-2645
US

V. Phone/Fax

Practice location:
  • Phone: 561-507-3533
  • Fax: 561-507-3533
Mailing address:
  • Phone: 561-507-3533
  • Fax: 561-507-3533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number1213645
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number1213645
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number1213645
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1213645
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1213645
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: