Provider Demographics
NPI:1053354555
Name:FERNANDEZ, ARTHUR R (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:R
Last Name:FERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14102 CABANA NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418
Mailing Address - Country:US
Mailing Address - Phone:361-949-9420
Mailing Address - Fax:
Practice Address - Street 1:14493 SOUTH PADRE ISLAND DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418
Practice Address - Country:US
Practice Address - Phone:713-204-8341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2617207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI60082Medicare UPIN