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Individual
LUIS G FERNANDEZ
Active
Individual
LUIS G FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
J5320
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110504103
—
TX
05
—
110504104
—
TX
01
—
86510S
BCBS
TX
01
—
8BC268
BCBS OF TEXAS
TX
01
—
TIN PLUS 096
TRICARE
TX
Enumeration date
05/17/2006
Last updated
10/13/2014
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