Provider Demographics
NPI:1144566951
Name:HERNANDEZ, HECTOR MARTIN (LPC)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:MARTIN
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 N LEE TREVINO DR STE A2
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3419
Mailing Address - Country:US
Mailing Address - Phone:915-400-7276
Mailing Address - Fax:
Practice Address - Street 1:1600 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5622
Practice Address - Country:US
Practice Address - Phone:915-599-4700
Practice Address - Fax:915-351-4467
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0153611101YM0800X
TX69923101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX344867201Medicaid