Provider Demographics
NPI:1033683974
Name:HINES, ANTOINE DIAS
Entity Type:Individual
Prefix:
First Name:ANTOINE
Middle Name:DIAS
Last Name:HINES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 E SERENE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-6507
Mailing Address - Country:US
Mailing Address - Phone:702-948-4848
Mailing Address - Fax:702-948-4845
Practice Address - Street 1:2961 E SERENE AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6507
Practice Address - Country:US
Practice Address - Phone:702-948-4848
Practice Address - Fax:702-948-4845
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker