Provider Demographics
NPI:1003628793
Name:HERNANDEZ, ERIC (FNP-C)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-5901
Mailing Address - Country:US
Mailing Address - Phone:915-245-5440
Mailing Address - Fax:
Practice Address - Street 1:14470 HORIZON BLVD STE AANDJ
Practice Address - Street 2:
Practice Address - City:HORIZON CITY
Practice Address - State:TX
Practice Address - Zip Code:79928-7695
Practice Address - Country:US
Practice Address - Phone:915-852-3225
Practice Address - Fax:915-209-8289
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1188079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily