Provider Demographics
NPI:1629684402
Name:HERNANDEZ, RAMON NOEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:NOEL
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 BARTON SKWY APT 1503
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7555
Mailing Address - Country:US
Mailing Address - Phone:424-385-4586
Mailing Address - Fax:
Practice Address - Street 1:13000 N INTERSTATE 35 STE 206
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-1030
Practice Address - Country:US
Practice Address - Phone:512-815-2524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX366791223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
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