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General NPI Number Information
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NPI Number | 1851187645
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Entity Type | Individual
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Provider Name | DANIEL HERNANDEZ
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Gender | Male
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 5113 MCNUTT RD UNIT 906
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City | SANTA TERESA
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State | NM
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Zip | 88008-9595
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Country | US
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Telephone | 915-218-3255
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Fax | 915-218-3255
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Provider Business Mailing Address
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Address Line | 5113 MCNUTT RD UNIT 906
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City | SANTA TERESA
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State | NM
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Zip | 88008-9595
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Country | US
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Telephone | 915-218-3255
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Fax | 915-218-3255
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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 | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 17-0804
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License Number State | NV
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