Organization
ELIEZER HERNANDEZ MD P.A.
Active
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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