Provider Demographics
NPI:1528225547
Name:HATO TEJAS PSC
Entity Type:Organization
Organization Name:HATO TEJAS PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-787-1946
Mailing Address - Street 1:PO BOX 3600
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00958-0600
Mailing Address - Country:US
Mailing Address - Phone:787-787-1946
Mailing Address - Fax:787-787-3708
Practice Address - Street 1:CARR 862 K M 2.7 HATO TEJAS
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00958-0600
Practice Address - Country:US
Practice Address - Phone:787-787-1946
Practice Address - Fax:787-787-3708
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HATO TEJAS PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography