MEDICARE: THELMA HERNANDEZ M.D.

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	207L00000X	Anesthesiology Physician	E7978	TX

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	:	1508934811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THELMA HERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 797
Second Line	:
City	:	LANCASTER
State	:	TX
Zip	:	75146-0797
Country	:	US
Telephone Number	:	254-694-5092
Fax Number	:	254-694-7039

Provider Business Practice Location Address
First Line	:	2009 N JEFFERSON AVE
Second Line	:
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-2336
Country	:	US
Telephone Number	:	254-694-5092
Fax Number	:	254-694-7039

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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