Provider Demographics
NPI:1952356586
Name:HERNANDEZ, CRISTELA (MD)
Entity type:Individual
Prefix:
First Name:CRISTELA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2171
Mailing Address - Fax:956-362-2487
Practice Address - Street 1:5119 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8278
Practice Address - Country:US
Practice Address - Phone:956-362-2090
Practice Address - Fax:956-362-2096
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0448207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125637206Medicaid
TX325389YNG9Medicare PIN
TX853335Medicare ID - Type Unspecified
TX0100531OtherUNITED HEALTH CARE