Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | N0148 | TX |
N | 208000000X | Pediatrician | N0148 | TX |
N | 2080P0203X | Pediatric Critical Care Doctor | N0148 | TX |
Y | 2080P0207X | Pediatric Hematology-Oncologist | N0148 | TX |
NPI | 1275715856 |
---|---|
Provider Name | Veronica Hernandez Jude |
First Address | San Antonio, TX 78207-3154 |
Second Address | San Antonio, TX 78207-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2007 |
Last Update Date | 19/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
197836304 | (05) | TX |
8F10109 | (02) | TX |