1528457827 NPI number — MR. HERMES DANIEL HERNANDEZ ALFONSO SR. FNP-C

Table of content: MR. HERMES DANIEL HERNANDEZ ALFONSO SR. FNP-C (NPI 1528457827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528457827 NPI number — MR. HERMES DANIEL HERNANDEZ ALFONSO SR. FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERNANDEZ ALFONSO
Provider First Name:
HERMES
Provider Middle Name:
DANIEL
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
FNP-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528457827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23441 YAUPON HILLS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW CANEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77357-3867
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
772-584-5543
Provider Business Mailing Address Fax Number:
713-492-2718

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
96 BERRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77022-3057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-492-2661
Provider Business Practice Location Address Fax Number:
713-492-2718
Provider Enumeration Date:
01/10/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  1022089 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163WG0000X , with the licence number: 787482 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 246ZC0007X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WA2000X , with the licence number: 1022089 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1760104616 . This is a "PRIVATE INSURANCE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".