Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 8327R | LA |
NPI | 1508863002 |
---|---|
Provider Name | Dr. Eduardo J Hernandez |
First Address | Slidell, LA 70458-8056 |
Second Address | Slidell, LA 70458-8056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E62862 | (02) | LA |