Basic Information
| Provider Information | |||||||||
| NPI: | 1487662482 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERNANDEZ | ||||||||
| FirstName: | HECTOR | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 90 | ||||||||
| Address2: | |||||||||
| City: | PLACIDA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339460090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417692672 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3501 S SONCY RD STE 140 | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063555625 | ||||||||
| FaxNumber: | 8063522245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 01/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | R8574 | TX | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 387478601 | 05 | TX | MEDICAID | 695647 | 01 | TX | MEDICARE | OTHER |