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Individual

LIZZA B HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
4502 MEDICAL DR FL 10, SAN ANTONIO, TX 78229-4402
(210) 358-2590
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 358-2590

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP129752
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
365280202
TX
01
365280203
CSHCN
TX
Enumeration date
12/04/2015
Last updated
11/21/2017
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