MEDICARE: JOSEPH P HERMOSA MD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	L4435	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	854488	OTHER	TX	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326287889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH P HERMOSA MD PLLC

Provider Business Mailing Address
First Line	:	402A W PALM VALLEY BLVD # 305
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-4237
Country	:	US
Telephone Number	:	512-360-1969
Fax Number	:	512-240-5026

Provider Business Practice Location Address
First Line	:	7230 WYOMING SPRINGS DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-4319
Country	:	US
Telephone Number	:	512-360-1969
Fax Number	:	512-240-5026

Authorized Official
Title or Position	:	OWNER
Name	:	JOSEPH P HERMOSA
Credential	:	MEDICAL DOCTOR
Telephone Number	:	512-630-1969

Provider Enumeration Date	:	02/06/2009
Last Update Date	:	07/05/2020

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