Provider Demographics
NPI:1639671118
Name:HERNANDEZ PEREZ, ARQUIMEDES (NP-C)
Entity Type:Individual
Prefix:
First Name:ARQUIMEDES
Middle Name:
Last Name:HERNANDEZ PEREZ
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18816 AMADOR AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-2707
Mailing Address - Country:US
Mailing Address - Phone:281-571-6843
Mailing Address - Fax:
Practice Address - Street 1:817 W JEFFERSON BLVD STE 130
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4924
Practice Address - Country:US
Practice Address - Phone:214-948-2989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1029219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily