Provider Demographics
NPI:1407997554
Name:FERNANDEZ, H FRED (DC)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:FRED
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 HIGHWAY 3162
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-3582
Mailing Address - Country:US
Mailing Address - Phone:985-632-2225
Mailing Address - Fax:
Practice Address - Street 1:320 HIGHWAY 3162
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-3582
Practice Address - Country:US
Practice Address - Phone:985-632-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor