Provider Demographics
NPI:1831270750
Name:HERNANDEZ, ERNESTO (MD)
Entity type:Individual
Prefix:
First Name:ERNESTO
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 W HOUSTON
Mailing Address - Street 2:SUITE 312
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205
Mailing Address - Country:US
Mailing Address - Phone:210-226-5971
Mailing Address - Fax:210-226-0103
Practice Address - Street 1:343 W HOUSTON
Practice Address - Street 2:SUITE 312
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205
Practice Address - Country:US
Practice Address - Phone:210-226-5971
Practice Address - Fax:210-226-0103
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7977207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00EJ52Medicare PIN