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General NPI Number Information
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NPI Number | 1619626397
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Entity Type | Individual
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Provider Name | DIMAS CATARINO HERNANDEZ LCDC
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Gender | Male
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 1005 AVENUE W
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City | BROWNWOOD
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State | TX
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Zip | 76801-6326
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Country | US
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Telephone | 734-274-3162
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Fax |
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Provider Business Mailing Address
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Address Line | 930 W PARKER RD STE 530A
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City | PLANO
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State | TX
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Zip | 75075-2359
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Country | US
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Telephone | 972-548-0209
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15830
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License Number State | TX
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