Provider Demographics
NPI:1497136725
Name:HERNANDEZ, ADRIANNA (PT)
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SPURS LN STE 340
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1680
Mailing Address - Country:US
Mailing Address - Phone:210-798-8585
Mailing Address - Fax:210-798-8580
Practice Address - Street 1:21 SPURS LN STE 340
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1680
Practice Address - Country:US
Practice Address - Phone:210-798-8585
Practice Address - Fax:210-798-8580
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12651712251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX439340YM9JOtherMEDICARE ID