Provider Demographics
NPI:1073197661
Name:HERNANDEZ, YVONNE ELIZABETH
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:ELIZABETH
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 1:2105 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-6306
Mailing Address - Country:US
Mailing Address - Phone:915-245-8822
Mailing Address - Fax:
Practice Address - Street 1:7500 N MESA ST STE 210
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3515
Practice Address - Country:US
Practice Address - Phone:915-307-7800
Practice Address - Fax:915-351-4001
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA14523208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice