Provider Demographics
NPI:1881173177
Name:HERNANDEZ, SILVIA ANNEL (COTA)
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:ANNEL
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 MIRASOL ST
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-8269
Mailing Address - Country:US
Mailing Address - Phone:956-472-7364
Mailing Address - Fax:
Practice Address - Street 1:5006 E EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-5008
Practice Address - Country:US
Practice Address - Phone:956-565-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211752224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant