Provider Demographics
NPI:1487662482
Name:HERNANDEZ, HECTOR N (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:N
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90
Mailing Address - Street 2:
Mailing Address - City:PLACIDA
Mailing Address - State:FL
Mailing Address - Zip Code:33946-0090
Mailing Address - Country:US
Mailing Address - Phone:941-769-2672
Mailing Address - Fax:
Practice Address - Street 1:3501 S SONCY RD STE 140
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119
Practice Address - Country:US
Practice Address - Phone:806-355-5625
Practice Address - Fax:806-352-2245
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8574207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX387478601Medicaid
TX695647OtherMEDICARE
FL10-81561OtherMEDICA
FL650845053003OtherMEDICAL MUTUAL
FL9361587OtherCIGNA
FL190170OtherHARVARD PILGRIM HPHC
FL26782OtherBCBS
FL00040240601OtherUNIVERA
FL2602762OtherGHI GROUP
FLFL0010380OtherTRICARE CHAMPUS
FL650845053003OtherMEDICAL MUTUAL
G08484Medicare UPIN