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Individual

BRIAN J HERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(510) 561-5491
Mailing address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(510) 561-5491

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
030074
NY
363A00000X
Physician Assistant
Primary
PA8364
TX
390200000X
Student in an Organized Health Care Education/Training Program
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000000
CA
Enumeration date
01/13/2022
Last updated
09/27/2024
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