MEDICARE: DR. ROSEMARY Z HERNANDEZ LPC-S

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	101YP2500X	Professional Counselor	60727	TX

General Provider Information

NPI Number	:	1336302025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSEMARY Z HERNANDEZ LPC-S

Provider Business Mailing Address
First Line	:	12790 FM 1560 N UNIT 680
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-2229
Country	:	US
Telephone Number	:	210-831-9417
Fax Number	:	210-201-1190

Provider Business Practice Location Address
First Line	:	12030 BANDERA RD STE 108-1030
Second Line	:
City	:	HELOTES
State	:	TX
Zip	:	78023-4735
Country	:	US
Telephone Number	:	210-831-9417
Fax Number	:	210-201-1190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	04/26/2022

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