Provider Demographics
NPI:1003433434
Name:HERNANDEZ, CATHY MARIA
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:MARIA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 MATAGORDA DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4628
Mailing Address - Country:US
Mailing Address - Phone:512-736-4664
Mailing Address - Fax:
Practice Address - Street 1:1912 MATAGORDA DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4628
Practice Address - Country:US
Practice Address - Phone:512-736-4664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist