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General NPI Number Information
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NPI Number | 1205162294
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Entity Type | Individual
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Provider Name | GRACIELA HERNANDEZ DDS, MSD
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Gender | Female
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 6516 M D ANDERSON BLVD RM 440
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City | HOUSTON
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State | TX
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Zip | 77030-3402
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Country | US
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Telephone | 317-418-0719
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Fax |
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Provider Business Mailing Address
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Address Line | 3 HERMANN MUSEUM CIRCLE DR APT 6201
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City | HOUSTON
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State | TX
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Zip | 77004-7980
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Country | US
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Telephone | 317-418-0719
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | F25015
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License Number State | TX
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