MEDICARE: FRED Z HERNANDEZ JR. LPC, LMFT

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	7398	TX
2	106H00000X	Marriage & Family Therapist	4110	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	:	1790791499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRED Z HERNANDEZ JR. LPC, LMFT

Provider Business Mailing Address
First Line	:	2300 W COMMERCE ST
Second Line	:	SUITE 107
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-3839
Country	:	US
Telephone Number	:	210-227-2707
Fax Number	:	210-225-7751

Provider Business Practice Location Address
First Line	:	2300 W COMMERCE ST
Second Line	:	SUITE 107
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-3839
Country	:	US
Telephone Number	:	210-227-2707
Fax Number	:	210-225-7751

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	03/16/2017

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