Provider Demographics
NPI:1902415839
Name:HERNANDEZ, DANIEL ELOY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ELOY
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 RESEARCH DR APT 4105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-5068
Mailing Address - Country:US
Mailing Address - Phone:281-723-5911
Mailing Address - Fax:
Practice Address - Street 1:8131 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4720
Practice Address - Country:US
Practice Address - Phone:210-263-1532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36405122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist