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Individual
DR. JIM B FERNANDEZ
Active
Individual
DR. JIM B FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
L2246
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1278600001
MEDICARE SUPPLIER NUMBER
TX
05
—
149109402
—
TX
01
—
L2246
TEXAS MEDICAL BOARD
TX
Enumeration date
06/20/2006
Last updated
02/03/2011
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