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Individual

DR. GABRIEL HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
6134 W LAKE MEAD BLVD, E-8, LAS VEGAS, NV 89108-2659
(702) 631-4144
(702) 631-9094
Mailing address
6134 W LAKE MEAD BLVD, E-8, LAS VEGAS, NV 89108-2659
(702) 631-4144
(702) 631-9094

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
11887T
CA
152W00000X
Optometrist
Primary
557
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
V105259
MEDICARE PTAN
NV
Enumeration date
12/01/2005
Last updated
04/26/2012
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