Individual
MITCHELL HERNANDEZ-LUCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
25134 BUTTERWICK DR, SPRING, TX 77389-3339
(713) 578-0697
Mailing address
25134 BUTTERWICK DR, SPRING, TX 77389-3339
(713) 578-0697
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00801
TX
Other
Enumeration date
01/02/2019
Last updated
04/02/2020
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