Provider Demographics
NPI:1508900671
Name:HERNANDO, ANA (MOT,OTR)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:
Last Name:HERNANDO
Suffix:
Gender:F
Credentials:MOT,OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 RED BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:75065-3618
Mailing Address - Country:US
Mailing Address - Phone:940-230-2200
Mailing Address - Fax:940-498-0296
Practice Address - Street 1:2435 W OAK ST STE B
Practice Address - Street 2:207 W HICKORY ST SUITE 213
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2329
Practice Address - Country:US
Practice Address - Phone:940-230-2200
Practice Address - Fax:940-498-0296
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2008-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108511225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist