Provider Demographics
NPI:1073394565
Name:HERNANDEZ, MILTON III (LPCA)
Entity Type:Individual
Prefix:MR
First Name:MILTON
Middle Name:
Last Name:HERNANDEZ
Suffix:III
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5475
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78523-5475
Mailing Address - Country:US
Mailing Address - Phone:956-280-1836
Mailing Address - Fax:
Practice Address - Street 1:2905 S DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-6259
Practice Address - Country:US
Practice Address - Phone:956-280-1836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health