Organization Active NPI

Mi Clinica Hispana LLC

  • Primary Care Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1093525206
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
MI CLINICA HISPANA LLC
Practice address
3505 Summerhill Rd Ste 5
Texarkana, TX 75503-3596
Phone
(903) 710-1400
Fax
(903) 710-1500
NPI assigned
Jan 9, 2025
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alaina Hernandez, FNP-CNPI 1992533285
Title
Nurse Practitioner
Phone
(903) 710-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NU Primary

Addresses

Primary practice location

3505 Summerhill Rd Ste 5
Texarkana, TX 75503-3596

Mailing address

3505 Summerhill Rd Ste 5
Texarkana, TX 75503-3596
Phone (903) 710-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250314001603 TX Part B Supplier - Clinic/Group Practice 0840712261 Receives reassigned benefits from 2 practitioners
Practice locations: Texarkana, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2316650Mi Clinica Hispana LLC3505 Summerhill Road Ste 5, Texarkana, TX 75503Certificate of waiverJan 8, 2027

National Provider Directory

National Provider Directory

Locations

3505 Summerhill Rd
Ste 5
Texarkana, TX 75503
Phone (903) 710-1400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1093525206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 SUMMERHILL RD STE 5",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033596",
            "telephone_number": "903-710-1400",
            "fax_number": "903-710-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 SUMMERHILL RD STE 5",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033596",
            "telephone_number": "903-710-1400",
            "fax_number": "903-710-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI CLINICA HISPANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ALAINA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "903-710-1400",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.