Provider Demographics
NPI:1417305731
Name:HERNANDEZ, MARGARET A
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 THOMAS LN
Mailing Address - Street 2:
Mailing Address - City:RIVER OAKS
Mailing Address - State:TX
Mailing Address - Zip Code:76114-3360
Mailing Address - Country:US
Mailing Address - Phone:817-791-8890
Mailing Address - Fax:817-731-4858
Practice Address - Street 1:4255 BRYANT IRVIN RD
Practice Address - Street 2:SUITE 108
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-4233
Practice Address - Country:US
Practice Address - Phone:817-731-4848
Practice Address - Fax:817-731-4858
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT010651173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist