Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 3044 | TX |
NPI | 1093245110 |
---|---|
Provider Name | Dr. Eduardo Antonio Hernandez |
First Address | Waco, TX 76711-1329 |
Second Address | Waco, TX 76711-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2017 |
Last Update Date | 14/09/2020 |