Provider Demographics
NPI:1912210790
Name:HERNANDEZ, ERIC VILLAPA
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:VILLAPA
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E RIDGE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1535
Mailing Address - Country:US
Mailing Address - Phone:956-686-2150
Mailing Address - Fax:866-287-3592
Practice Address - Street 1:1400 E RIDGE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1535
Practice Address - Country:US
Practice Address - Phone:956-686-2150
Practice Address - Fax:866-287-3592
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113741225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist