Provider Demographics
NPI:1932126596
Name:CARLOS HERNANDEZ, M.D., P.A.
Entity Type:Organization
Organization Name:CARLOS HERNANDEZ, M.D., P.A.
Other - Org Name:SOUTHWESTERN WOMEN'S CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-758-1633
Mailing Address - Street 1:1975 N VETERANS BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4456
Mailing Address - Country:US
Mailing Address - Phone:830-758-1633
Mailing Address - Fax:830-773-6989
Practice Address - Street 1:1975 N VETERANS BLVD STE 6
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4456
Practice Address - Country:US
Practice Address - Phone:830-758-1633
Practice Address - Fax:830-773-6989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182277701Medicaid
TX45D0906615OtherCLIA