Provider Demographics
NPI:1598849994
Name:PATRICIA G HERNANDEZ
Entity Type:Organization
Organization Name:PATRICIA G HERNANDEZ
Other - Org Name:LA SIERRA LINDA ADC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-428-9270
Mailing Address - Street 1:1514 S 77 SUNSHINE STRIP
Mailing Address - Street 2:SUITE #6
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8186
Mailing Address - Country:US
Mailing Address - Phone:956-428-9270
Mailing Address - Fax:956-428-9939
Practice Address - Street 1:1514 S 77 SUNSHINE STRIP
Practice Address - Street 2:SUITE #6
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8186
Practice Address - Country:US
Practice Address - Phone:956-428-9270
Practice Address - Fax:956-428-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123612261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001004676OtherDAHS