Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | F25015 | TX |
NPI | 1205162294 |
---|---|
Provider Name | Dr. Graciela Hernandez |
First Address | Houston, TX 77004-7980 |
Second Address | Houston, TX 77030-3402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2009 |
Last Update Date | 26/10/2009 |