Individual provider Active NPI

Mario Hernandez, PHARM D.

  • Pharmacist
  • Amarillo, TX
National Provider Identifier
1104154095
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
39277 Issued in TX
Practice address
801 N Fillmore St
Amarillo, TX 79107-3763
Phone
(806) 371-8116
NPI assigned
Dec 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 39277 TX Primary

Addresses

Primary practice location

801 N Fillmore St
Amarillo, TX 79107-3763

Mailing address

421 Maple St
Amarillo, TX 79107-3841
Phone (806) 383-2746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
39277TXMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1104154095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 MAPLE ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791073841",
            "telephone_number": "806-383-2746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N FILLMORE ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791073763",
            "telephone_number": "806-371-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-03",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "39277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.