Provider Demographics
NPI:1134097686
Name:FERNANDEZ, DACIA ANNA (APRN)
Entity type:Individual
Prefix:
First Name:DACIA
Middle Name:ANNA
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 GULF FWY S
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5143
Mailing Address - Country:US
Mailing Address - Phone:713-834-6647
Mailing Address - Fax:
Practice Address - Street 1:2280 GULF FWY S
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5143
Practice Address - Country:US
Practice Address - Phone:713-563-0670
Practice Address - Fax:713-834-6641
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1194976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty