Provider Demographics
NPI:1528486107
Name:HERNANDEZ, AURELIO (LSA)
Entity type:Individual
Prefix:
First Name:AURELIO
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 ZURICH AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6332
Mailing Address - Country:US
Mailing Address - Phone:956-778-5292
Mailing Address - Fax:
Practice Address - Street 1:2428 ZURICH AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6332
Practice Address - Country:US
Practice Address - Phone:956-778-5292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1192246ZX2200X
246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSA00890OtherLSA-TMB