Provider Demographics
NPI:1215418249
Name:HERNANDEZ, XAVIER ESTEBAN (MOTR/L)
Entity Type:Individual
Prefix:
First Name:XAVIER
Middle Name:ESTEBAN
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8602 CINNAMON CREEK DR APT 1705
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1475
Mailing Address - Country:US
Mailing Address - Phone:830-776-0834
Mailing Address - Fax:
Practice Address - Street 1:8602 CINNAMON CREEK DR APT 1705
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1475
Practice Address - Country:US
Practice Address - Phone:830-776-0834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114388225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist