Basic Information
| Provider Information | |||||||||
| NPI: | 1386267417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERNANDEZ | ||||||||
| FirstName: | OMAR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | SR. | ||||||||
| Credential: | RCP, RRT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 807 | ||||||||
| Address2: | |||||||||
| City: | OLMITO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785750807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9565512741 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1102 W TRENTON RD | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785399105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563886000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2020 | ||||||||
| LastUpdateDate: | 05/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 227900000X | RCP00077169 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered |
No ID Information.