Provider Demographics
NPI:1467219311
Name:HERMESDHALF LLC
Entity Type:Organization
Organization Name:HERMESDHALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:HERNANDEZ ALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-584-5543
Mailing Address - Street 1:8950 WILL CLAYTON PKWY STE I
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5856
Mailing Address - Country:US
Mailing Address - Phone:832-644-8230
Mailing Address - Fax:832-644-8429
Practice Address - Street 1:8950 WILL CLAYTON PKWY STE I
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5856
Practice Address - Country:US
Practice Address - Phone:832-644-8230
Practice Address - Fax:832-644-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty