Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | H8925 | TX |
Y | 208600000X | Surgeon | H8925 | TX |
N | 2082S0105X | Plastic Hand Surgeon | H8925 | TX |
NPI | 1114927258 |
---|---|
Provider Name | Dr. Robert A Fernandez |
First Address | Corpus Christi, TX 78404 |
Second Address | Corpus Christi, TX 78404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 26/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116146504 | (05) | TX |
F44260 | (02) | TX |