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General NPI Number Information
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NPI Number | 1063384451
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Entity Type | Individual
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Provider Name | JESUS JOSE HERNANDEZ JR. APRN
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Gender | Male
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 1600 WALLACE BLVD
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City | AMARILLO
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State | TX
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Zip | 79106-1799
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Country | US
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Telephone | 806-212-2129
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Fax |
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Provider Business Mailing Address
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Address Line | 5813 S RUSK ST
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City | AMARILLO
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State | TX
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Zip | 79118-8812
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Country | US
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Telephone | 806-212-2129
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1212432
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License Number State | TX
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