Individual
MODESTO HERNANDEZ III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1400 N WESTGATE DR STE 203, WESLACO, TX 78596-3996
(956) 565-2929
(956) 565-6939
Mailing address
PO BOX 1724, WESLACO, TX 78599-1724
(956) 532-7598
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1159458
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T6944
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/20/2005
Last updated
07/08/2007
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