Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | H5899 | TX |
NPI | 1053407296 |
---|---|
Provider Name | Peter D Hino |
First Address | Dallas, TX 75231-4482 |
Second Address | Dallas, TX 75231-4482 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 10/02/2022 |