Organization
ELIEZER HERNANDEZ MD P.A.
Active
Other names
Yeled Shalom Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIEZER HERNANDEZ M.D.,P.A. (OWNER)
(830) 773-9449
Entity
Organization
Contact information
Practice address
1975 N VETERANS BLVD, STE. 5, EAGLE PASS, TX 78852-4456
(830) 773-9449
(830) 757-3142
Mailing address
PO BOX 1145, EAGLE PASS, TX 78853-1145
(830) 773-9449
(830) 757-3142
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
J6834
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063670601
—
TX
05
—
153805001
—
TX
05
—
153805002
—
TX
Enumeration date
04/26/2006
Last updated
11/25/2024
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