=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871908178
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEJANDRO HERNANDEZ HERNANDEZ MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2014
-----------------------------------------------------
Last Update Date | 07/06/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2810 W EXPRESSWAY 83
-----------------------------------------------------
City | MERCEDES
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78570-9704
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-734-9067
-----------------------------------------------------
Fax | 956-734-9068
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2410 SAN ALEJANDRO
-----------------------------------------------------
City | MISSION
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78572-7281
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-287-1532
-----------------------------------------------------
Fax | 956-215-7459
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207PE0005X
-----------------------------------------------------
Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
-----------------------------------------------------
License Number | R0246
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | BP10051015
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | R0246
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 2083P0011X
-----------------------------------------------------
Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
-----------------------------------------------------
License Number | R0246
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------