Individual
JON E HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
13601 PRESTON RD, STE 1000W, DALLAS, TX 75240-4911
(972) 663-8523
(972) 663-8329
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
533546
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159873202
—
TX
05
—
159873203
—
TX
01
—
84219U
BCBSTX
TX
01
—
89662U
BCBS
TX
01
—
P00719196
RAILROAD
TX
Enumeration date
05/04/2006
Last updated
10/15/2012
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