Provider Demographics
NPI:1972288546
Name:HERNANDEZ, ADELINA (RSPS, DMETA)
Entity Type:Individual
Prefix:
First Name:ADELINA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:RSPS, DMETA
Other - Prefix:
Other - First Name:ADELINA
Other - Middle Name:
Other - Last Name:OLIVARES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RSPS, DMETA
Mailing Address - Street 1:486 CRIPPLE CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:TX
Mailing Address - Zip Code:78516-9336
Mailing Address - Country:US
Mailing Address - Phone:915-273-8248
Mailing Address - Fax:
Practice Address - Street 1:116 S 12TH AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4502
Practice Address - Country:US
Practice Address - Phone:915-273-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18010623175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist