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General NPI Number Information
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NPI Number | 1093525206
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Entity Type | Organization
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Legal Business Name | MI CLINICA HISPANA LLC
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 3505 SUMMERHILL RD STE 5
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City | TEXARKANA
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State | TX
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Zip | 75503-3596
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Country | US
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Telephone | 903-710-1400
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Fax | 903-710-1500
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Provider Business Mailing Address
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Address Line | 3505 SUMMERHILL RD STE 5
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City | TEXARKANA
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State | TX
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Zip | 75503-3596
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Country | US
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Telephone | 903-710-1400
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Fax | 903-710-1500
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | ALAINA HERNANDEZ
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Credential | FNP-C
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Telephone | 903-710-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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