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General NPI Number Information
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NPI Number | 1831135953
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Entity Type | Individual
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Provider Name | JIM B FERNANDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 02/03/2011
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Provider Practice Location Address
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Address Line | 900 W 38TH ST #300
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City | AUSTIN
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State | TX
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Zip | 78705-1127
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Country | US
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Telephone | 512-450-1300
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Fax | 512-450-1339
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Provider Business Mailing Address
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Address Line | 900 W 38TH ST #300
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City | AUSTIN
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State | TX
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Zip | 78705-1127
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Country | US
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Telephone | 512-450-1300
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Fax | 512-450-1339
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | L2246
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License Number State | TX
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