Provider Demographics
NPI:1841377041
Name:HERNANDEZ, ALFRED JOE JR (MD)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:JOE
Last Name:HERNANDEZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12206 CLEARFORK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2513
Mailing Address - Country:US
Mailing Address - Phone:281-497-8755
Mailing Address - Fax:281-497-8755
Practice Address - Street 1:12206 CLEARFORK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-2513
Practice Address - Country:US
Practice Address - Phone:281-497-8755
Practice Address - Fax:281-487-8755
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD5037207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10035414OtherAMERIVANTAGE
TX031864401Medicaid
TX103900009OtherPALMETTO GBA RR MEDICARE
TX2900312OtherEVERCARE CHOICE
TX2900312OtherEVERCARE CHOICE
TX00AH75Medicare ID - Type Unspecified