Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | H3322 | TX |
NPI | 1063446359 |
---|---|
Provider Name | Timothy Reed Hines |
First Address | Austin, TX 78751-3014 |
Second Address | Austin, TX 78751-3014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 14/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
134942509 | (05) | TX |