Provider Demographics
NPI:1689497463
Name:HERNANDEZ, ZACHARY NOAH
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:NOAH
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4013 PECAN GRV
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:TX
Mailing Address - Zip Code:77510-8632
Mailing Address - Country:US
Mailing Address - Phone:832-418-0648
Mailing Address - Fax:
Practice Address - Street 1:3730 KIRBY DR STE 1120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3994
Practice Address - Country:US
Practice Address - Phone:832-315-5793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205539106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist