Basic Information
| Provider Information | |||||||||
| NPI: | 1093783490 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERNANDEZ | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | STEVEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 902 POLISHED STONE CV | ||||||||
| Address2: | |||||||||
| City: | PFLUGERVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786604795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5129900123 | ||||||||
| FaxNumber: | 5124778933 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 E 15TH ST | ||||||||
| Address2: | BRACKENRIDGE HOSPITAL ANNEX | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787011930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123248355 | ||||||||
| FaxNumber: | 5124778933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 12/27/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | M2976 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.