Clinica Hispana Eben-Ezer LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

CLINICA HISPANA EBEN-EZER LLC

Practice address

4043 Trinity Mills Rd Ste 103
Dallas, TX 75287-6757

Phone

(972) 707-9999

NPI assigned

May 15, 2025

Last updated

Sep 10, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Oscar Pena Hernandez

Title

Owner

Phone

(469) 864-9165

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Maribel Jacobo Hernandez, APRN

  • Family Nurse Practitioner
  • Homestead, FL
  • NPI 1689221822

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1932990272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 TRINITY MILLS RD STE 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876757",
            "telephone_number": "972-707-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4043 TRINITY MILLS RD STE 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876757",
            "telephone_number": "972-707-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA HISPANA EBEN-EZER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "PENA HERNANDEZ",
        "authorized_official_first_name": "OSCAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-864-9165"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.