Provider Demographics
NPI:1740380377
Name:HERNANDEZ, SANDRA LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LUZ
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:LUZ
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2000B TRANSMOUNTAIN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79911-3600
Mailing Address - Country:US
Mailing Address - Phone:915-541-1144
Mailing Address - Fax:915-541-1170
Practice Address - Street 1:2000B TRANSMOUNTAIN RD STE 200
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79911-3600
Practice Address - Country:US
Practice Address - Phone:915-541-1144
Practice Address - Fax:915-541-1170
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040400207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology