Provider Demographics
NPI:1629070909
Name:HERNANDEZ, MIGUEL ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 N 2ND ST STE A
Mailing Address - Street 2:COL ROWE BLVD
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2303
Mailing Address - Country:US
Mailing Address - Phone:956-618-4414
Mailing Address - Fax:956-630-4136
Practice Address - Street 1:1421 N 2ND ST STE A
Practice Address - Street 2:COL ROWE BLVD
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2303
Practice Address - Country:US
Practice Address - Phone:956-618-4414
Practice Address - Fax:956-630-4136
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3494207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0181407OtherUNITED HEALTH CARE
TX88280FOtherBLUE CROSS BLUE SHIELD
TX130420603Medicaid
TX130420604Medicaid
TX2173576OtherBLUELINK
TX447300OtherAETNA
TX124283OtherSUPERIOR HEALTH PLAN
TX130420603Medicaid
TX2173576OtherBLUELINK
TX200014563Medicare PIN
TX88280FOtherBLUE CROSS BLUE SHIELD