Provider Demographics
NPI:1881966380
Name:HERNANDEZ, NINA NATASHA (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:NATASHA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 N GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-3868
Mailing Address - Country:US
Mailing Address - Phone:956-463-3905
Mailing Address - Fax:
Practice Address - Street 1:1324 COMMON STREET
Practice Address - Street 2:SUITE 307
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3566
Practice Address - Country:US
Practice Address - Phone:830-625-7310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1212432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist