Provider Demographics
NPI:1447268248
Name:FERNANDEZ, ORLANDO JR (DC)
Entity type:Individual
Prefix:DR
First Name:ORLANDO
Middle Name:
Last Name:FERNANDEZ
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 BROADWAY ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4900
Mailing Address - Country:US
Mailing Address - Phone:281-485-7002
Mailing Address - Fax:
Practice Address - Street 1:2640 BROADWAY ST
Practice Address - Street 2:SUITE 113
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4900
Practice Address - Country:US
Practice Address - Phone:281-485-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609266Medicare ID - Type UnspecifiedPROVIDER NUMBER
TXU76329Medicare UPIN