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General NPI Number Information
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NPI Number | 1821301979
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Entity Type | Organization
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Legal Business Name | JUAN A. HERNANDEZ, M.D., P.A.
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 232 N JOHN REDDITT DR STE B
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City | LUFKIN
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State | TX
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Zip | 75904-2620
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Country | US
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Telephone | 936-634-7225
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Fax | 936-639-4549
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Provider Business Mailing Address
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Address Line | 232 N JOHN REDDITT DR STE B
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City | LUFKIN
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State | TX
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Zip | 75904-2620
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Country | US
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Telephone | 936-634-7225
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Fax | 936-639-4549
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUAN A. HERNANDEZ
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Credential | M.D.
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Telephone | 936-634-7225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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