Provider Demographics
NPI:1457111379
Name:VICTORIA HERNANDEZ
Entity Type:Organization
Organization Name:VICTORIA HERNANDEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-244-3737
Mailing Address - Street 1:2 LADEN CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-2403
Mailing Address - Country:US
Mailing Address - Phone:210-387-0238
Mailing Address - Fax:518-244-5292
Practice Address - Street 1:2 LADEN CRK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-2403
Practice Address - Country:US
Practice Address - Phone:210-387-0238
Practice Address - Fax:518-244-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty