Provider Demographics
NPI:1063182467
Name:HERNANDEZ NAVARRO, ANELYS M
Entity type:Individual
Prefix:
First Name:ANELYS
Middle Name:M
Last Name:HERNANDEZ NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11603 WATERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7400
Mailing Address - Country:US
Mailing Address - Phone:281-299-5577
Mailing Address - Fax:
Practice Address - Street 1:300 E CEDAR STREET
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515
Practice Address - Country:US
Practice Address - Phone:281-299-5577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2023-12-13
Deactivation Date:2021-10-13
Deactivation Code:
Reactivation Date:2023-12-12
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician