Provider Demographics
NPI:1043243843
Name:FERNANDEZ AND ASSOCIATES
Entity Type:Organization
Organization Name:FERNANDEZ AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISAIRIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-943-3367
Mailing Address - Street 1:1007 EDGEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-1801
Mailing Address - Country:US
Mailing Address - Phone:713-943-3367
Mailing Address - Fax:713-943-3476
Practice Address - Street 1:1007 EDGEBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-1801
Practice Address - Country:US
Practice Address - Phone:713-943-3367
Practice Address - Fax:713-943-3476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9627207VG0400X
TXE9626208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111598201Medicaid
TX111598201Medicaid