Provider Demographics
NPI:1952373045
Name:HERNANDEZ, CARLOTA (MD)
Entity Type:Individual
Prefix:
First Name:CARLOTA
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 1:4602 N. BARTLETT
Mailing Address - Street 2:VA CLINIC
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041
Mailing Address - Country:US
Mailing Address - Phone:956-523-7850
Mailing Address - Fax:956-523-7865
Practice Address - Street 1:4602 N. BARTLETT
Practice Address - Street 2:VA, CLINIC
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041
Practice Address - Country:US
Practice Address - Phone:956-523-7850
Practice Address - Fax:956-523-7865
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine