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General NPI Number Information
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NPI Number | 1407996655
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Entity Type | Individual
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Provider Name | LYDIA HERNANDEZ-PEREZ SLP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1713 E MAIN ST
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City | ALICE
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State | TX
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Zip | 78332-4047
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Country | US
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Telephone | 361-396-0243
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Fax | 361-396-0273
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Provider Business Mailing Address
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Address Line | 1113 E WARREN AVE
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City | KINGSVILLE
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State | TX
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Zip | 78363-6470
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Country | US
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Telephone | 361-522-6674
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 18531
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License Number State | TX
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