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NPI Code Detail

MEDICARE: DR. JOSE MANUEL HERNANDEZ M.D.

MEDICARE: DR. JOSE MANUEL 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
12084P0800XPsychiatry PhysicianF2282TX
22084P0804XChild & Adolescent Psychiatry PhysicianF2282TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AY97OTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558460386
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE MANUEL HERNANDEZ M.D.
Provider Business Mailing Address
First Line : 10807 PERN BETL RD STE 300
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78217-3144
Country : US
Telephone Number : 210-245-7862
Fax Number : 210-245-7951
Provider Business Practice Location Address
First Line : 10807 PERN BETL RD STE 300
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78217-3144
Country : US
Telephone Number : 210-245-7862
Fax Number : 210-245-7951
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 06/20/2024

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