Provider Demographics
NPI:1053565002
Name:HERNANDEZ, SYLVIA LIZETTE (OTR)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:LIZETTE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:LIZETTE
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:808 W BLUE JAY AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-8898
Mailing Address - Country:US
Mailing Address - Phone:956-784-0662
Mailing Address - Fax:
Practice Address - Street 1:808 W BLUE JAY AVE
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-8898
Practice Address - Country:US
Practice Address - Phone:956-784-0662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112070225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist