Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2015017145 | MO |
Y | 207QA0505X | Family Doctor - Adult Medicine | R6413 | TX |
NPI | 1336520717 |
---|---|
Provider Name | Andrew Jerry Hinojosa |
First Address | Corpus Christi, TX 78414-2402 |
Second Address | Corpus Christi, TX 78414-2402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2015 |
Last Update Date | 01/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1336520717 | (05) | TX |