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NPI Code Detail

MEDICARE: DAWN ADELE HERNANDEZ

MEDICARE: DAWN ADELE HERNANDEZ
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
1225100000XPhysical Therapist1207406TX

General Provider Information

NPI Number : 1740568112
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN ADELE HERNANDEZ
Provider Business Mailing Address
First Line : 12952 BANDERA RD STE 107
Second Line :
City : HELOTES
State : TX
Zip : 78023-4733
Country : US
Telephone Number : 210-372-9600
Fax Number : 210-372-0211
Provider Business Practice Location Address
First Line : 12952 BANDERA RD STE 107
Second Line :
City : HELOTES
State : TX
Zip : 78023-4733
Country : US
Telephone Number : 210-372-9600
Fax Number : 210-372-0211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2011
Last Update Date : 08/02/2011

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Directions to “ DAWN ADELE HERNANDEZ ” Practice Location

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