Individual
CRISTIAN BLAKE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13601 PRESTON RD, DALLAS, TX 75240-4911
(972) 702-0300
Mailing address
13601 PRESTON RD STE 210W, DALLAS, TX 75240-4986
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1021828
TX
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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