Provider Demographics
NPI:1255458493
Name:HERNANDEZ, SHEILA (DMD)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 N LOOP 1604 W
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2897
Mailing Address - Country:US
Mailing Address - Phone:210-694-2700
Mailing Address - Fax:210-694-2708
Practice Address - Street 1:8202 N LOOP 1604 W
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2897
Practice Address - Country:US
Practice Address - Phone:210-694-2700
Practice Address - Fax:210-694-2708
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205601223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry