Provider Demographics
NPI:1295013464
Name:HERNANDEZ-BYERS, PATRICIA MARIA EUGENIA (CCM)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARIA EUGENIA
Last Name:HERNANDEZ-BYERS
Suffix:
Gender:F
Credentials:CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 N CHERRY BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-3833
Mailing Address - Country:US
Mailing Address - Phone:405-824-7446
Mailing Address - Fax:
Practice Address - Street 1:726 N CHERRY BRANCH WAY
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-3833
Practice Address - Country:US
Practice Address - Phone:405-824-7446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7603171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator