Provider Demographics
NPI:1003947672
Name:FERNANDEZ, YAMILET (LSA)
Entity type:Individual
Prefix:
First Name:YAMILET
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 STEELE RANCH CT
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3886
Mailing Address - Country:US
Mailing Address - Phone:713-818-2895
Mailing Address - Fax:281-993-4644
Practice Address - Street 1:2405 STEELE RANCH CT
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3886
Practice Address - Country:US
Practice Address - Phone:713-818-2895
Practice Address - Fax:281-993-4644
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00293246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist