Individual
JOHN A HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 COTTAGE RD, CARTHAGE, TX 75633-1466
(903) 693-3841
(903) 694-4633
Mailing address
PO BOX 549, CARTHAGE, TX 75633-0549
(903) 693-3841
(903) 694-4633
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
222941
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C42P
BLUE CROSS CRNA
TX
Enumeration date
11/06/2006
Last updated
07/08/2007
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