Provider Demographics
NPI:1356886881
Name:HERNANDEZ, VICTOR HUGO (MED)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:HUGO
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 809
Mailing Address - Street 2:
Mailing Address - City:PRESIDIO
Mailing Address - State:TX
Mailing Address - Zip Code:79845-0809
Mailing Address - Country:US
Mailing Address - Phone:915-474-4343
Mailing Address - Fax:
Practice Address - Street 1:202 WEST O'REILLY
Practice Address - Street 2:
Practice Address - City:PRESIDIO
Practice Address - State:TX
Practice Address - Zip Code:79845-0809
Practice Address - Country:US
Practice Address - Phone:915-474-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73028101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health