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General NPI Number Information
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NPI Number | 1992059463
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS ADVANCED PRACTICE SOLUTIONS, LLC
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 44 W JEFFERSON ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6258
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Country | US
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Telephone | 956-544-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 44 W JEFFERSON ST
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City | BROWNSVILLE
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State | TX
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Zip | 78520-6258
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Country | US
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Telephone | 956-544-0123
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. EDER HERNANDEZ
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Credential | P.A
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Telephone | 956-544-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J9582
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License Number State | TX
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