Provider Demographics
NPI:1467767897
Name:HERDZ INC.
Entity Type:Organization
Organization Name:HERDZ INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-590-2524
Mailing Address - Street 1:12222 ROBERTA LYNNE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6809
Mailing Address - Country:US
Mailing Address - Phone:915-590-2524
Mailing Address - Fax:
Practice Address - Street 1:4007 RIO YAQUI
Practice Address - Street 2:
Practice Address - City:CD.JUAREZ
Practice Address - State:CHIH.
Practice Address - Zip Code:32310
Practice Address - Country:MX
Practice Address - Phone:656-616-4464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ4991336122300000X
ZZ3589415122300000X
ZZ4132190122300000X
ZZ3356666122300000X
ZZ3023198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty