Provider Demographics
NPI:1598053423
Name:HERNANDEZ GARCIA, JUAN CARLOS ISRAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN CARLOS
Middle Name:ISRAEL
Last Name:HERNANDEZ GARCIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13650 EASTLAKE BLVD STE A-104
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-7473
Mailing Address - Country:US
Mailing Address - Phone:915-216-6182
Mailing Address - Fax:
Practice Address - Street 1:13650 EASTLAKE BLVD STE A-104
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-7473
Practice Address - Country:US
Practice Address - Phone:915-260-8013
Practice Address - Fax:915-213-0628
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2023-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXQ1165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine