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ELIEZER HERNANDEZ MD P.A. NPI 1770540684


NPI Information

NPI: 1770540684
Provider Name: ELIEZER HERNANDEZ MD P.A.

Doing Business As: YELED SHALOM PEDIATRIC CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 45D2246002

Address:
1975 N VETERANS BLVD
STE. 5
EAGLE PASS, TX
ZIP 78852
Phone: (830) 773-9449
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ELIEZER HERNANDEZ MD P.A. is a rural health clinic center in Eagle Pass, TX. ELIEZER HERNANDEZ MD P.A. NPI is 1770540684. The provider is registered as an organization entity type.
The provider Is Doing Business As Yeled Shalom Pediatric Clinic.

The provider's business location address is:

1975 N VETERANS BLVD
STE. 5
EAGLE PASS, TX
ZIP 78852-456
Phone: (830) 773-9449
Fax: (830) 757-3142

The provider's authorized official is Eliezer Hernandez .
The authorized official title is Owner and has the following contact phone number (830) 773-9449.

The CLIA number assigned to this NPI record is 45D2246002 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/26/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural HealthJ6834TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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