Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 15327 | TX |
N | 213EG0000X | General Practice | 15327 | TX |
Y | 1223P0221X | Pediatric Dentist | 15327 | TX |
NPI | 1053539288 |
---|---|
Provider Name | Daniel Hinckley |
First Address | San Angelo, TX 76904-6831 |
Second Address | San Angelo, TX 76904-6831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 16/07/2007 |