Provider Demographics
NPI:1073794251
Name:HARRY HERNANDEZ, D.O.
Entity Type:Organization
Organization Name:HARRY HERNANDEZ, D.O.
Other - Org Name:ALAMO OSTEOPATHIC PHYSICIANS AND SURGEONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-656-4363
Mailing Address - Street 1:12650 NACOGDOCHES RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-2118
Mailing Address - Country:US
Mailing Address - Phone:210-656-4363
Mailing Address - Fax:
Practice Address - Street 1:12650 NACOGDOCHES RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-2118
Practice Address - Country:US
Practice Address - Phone:210-656-4363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4130207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613114Medicare PIN