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General NPI Number Information
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NPI Number | 1861464026
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Entity Type | Organization
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Legal Business Name | MAXIMILIANO HERNANDEZ MD PA
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 06/04/2018
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Provider Practice Location Address
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Address Line | 502 S CAGE BLVD
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City | PHARR
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State | TX
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Zip | 78577
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Country | US
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Telephone | 956-702-1013
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Fax | 956-781-5796
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Provider Business Mailing Address
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Address Line | PO BOX 644
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City | PHARR
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State | TX
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Zip | 78577-1612
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Country | US
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Telephone | 956-702-1013
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Fax | 956-781-5796
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Authorized Official
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Title or Position | OWNER
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Name | MAXIMILIANO HERNANDEZ
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Credential | M.D.
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Telephone | 956-702-1013
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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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