Provider Demographics
NPI:1013915503
Name:HERNANDEZ, ALVARO A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:A
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4646 N MESA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6104
Mailing Address - Country:US
Mailing Address - Phone:915-533-1628
Mailing Address - Fax:915-533-1723
Practice Address - Street 1:4646 N MESA
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3584
Practice Address - Country:US
Practice Address - Phone:915-313-6300
Practice Address - Fax:915-313-6300
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3459207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110328504Medicaid
TX293156YPUVMedicare PIN
TX110328504Medicaid
TX00A83WMedicare UPIN
TX741852587OtherBRAVO HEALTH