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General NPI Number Information
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NPI Number | 1912548512
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Entity Type | Individual
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Provider Name | MARIO ALONSO HERNANDEZ MSN, APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 301 HUDSPETH ST
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City | SONORA
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State | TX
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Zip | 76950-8004
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Country | US
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Telephone | 325-374-0883
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Fax |
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Provider Business Mailing Address
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Address Line | 308 HUDSPETH ST
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City | SONORA
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State | TX
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Zip | 76950-8003
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP143348
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License Number State | TX
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