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Mitchell Hernandez-Lucio, LSA

Physician Assistant, Surgical in Spring, TX. Individual provider (NPI-1).

NPI number1982177986
StatusActive
Last updated in NPPESApr 2, 2020

Details

NPI
1982177986
Entity type
Individual (NPI-1)
Name
Mitchell Hernandez-Lucio
Credential
LSA
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 2, 2019
Certification date
Apr 2, 2020
Last updated
Apr 2, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AS0400X Physician Assistant, SurgicalSA00801TXYes

Practice location

25134 Butterwick Dr
Spring, TX 77389-3339

Phone 713-578-0697

Mailing address

25134 Butterwick Dr
Spring, TX 77389-3339

Phone 713-578-0697

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