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General NPI Number Information
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NPI Number | 1700679818
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Entity Type | Individual
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Provider Name | EDGAR ALEXANDER HERNANDEZ PARRA D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 705 HOBBS HWY
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City | SEMINOLE
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State | TX
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Zip | 79360-3401
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Country | US
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Telephone | 432-245-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 119 ROOSEVELT AVE UNIT 6
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City | JERSEY CITY
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State | NJ
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Zip | 07304-1245
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Country | US
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Telephone | 786-470-6603
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI03092500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 41446
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License Number State | TX
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