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Individual

PEDRO R HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D. P.A.

Contact information

Practice address
1901 MEDI PARK, SUITE 138, AMARILLO, TX 79106-2110
(806) 355-3364
(806) 355-0108
Mailing address
1901 MEDI PARK, SUITE 138, AMARILLO, TX 79106-2110

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E5385
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00RJ36
BCBS OF TEXAS
TX
01
115014100
FIRSTCARE/SOUTHWEST LIFE
TX
05
134882305
TX
01
4209208
AETNA
TX
05
E7319
NM
Enumeration date
09/30/2005
Last updated
06/20/2019
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