Provider Demographics
NPI:1619626397
Name:HERNANDEZ, DIMAS CATARINO (LCDC)
Entity Type:Individual
Prefix:MR
First Name:DIMAS
Middle Name:CATARINO
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 W PARKER RD STE 530A
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-2359
Mailing Address - Country:US
Mailing Address - Phone:972-548-0209
Mailing Address - Fax:
Practice Address - Street 1:1005 AVENUE W
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-6326
Practice Address - Country:US
Practice Address - Phone:734-274-3162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15830101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)