Provider Demographics
NPI:1275605040
Name:HERNANDEZ, STEVEN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 GATEWAY CENTRAL STE 201
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-6356
Mailing Address - Country:US
Mailing Address - Phone:830-693-7044
Mailing Address - Fax:830-693-2069
Practice Address - Street 1:608 GATEWAY CENTRAL STE 201
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-6356
Practice Address - Country:US
Practice Address - Phone:830-693-7044
Practice Address - Fax:830-693-2069
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144377201Medicaid