Individual
JACCOB DANIEL HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2715 CORNERSTONE BLVD, EDINBURG, TX 78539-8464
(956) 627-2717
Mailing address
4206 SAN GABRIEL ST APT 14206, MISSION, TX 78572-6694
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
882580
TX
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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