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General NPI Number Information
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NPI Number | 1922875574
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Entity Type | Individual
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Provider Name | HECTOR HERNANDEZ BUCIO
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Gender | Male
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 5923 GRANDWOOD DR
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City | SAN ANTONIO
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State | TX
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Zip | 78239-1507
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Country | US
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Telephone | 210-462-3468
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Fax |
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Provider Business Mailing Address
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Address Line | 5923 GRANDWOOD DR
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City | SAN ANTONIO
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State | TX
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Zip | 78239-1507
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number | PTTC3289
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | NA0060034548
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | MA0000049870
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License Number State | TX
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