Provider Demographics
NPI:1184642191
Name:HINOJOSA, MARCUS DANIEL (OD)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:DANIEL
Last Name:HINOJOSA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 MUSSER ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-2360
Mailing Address - Country:US
Mailing Address - Phone:956-727-1843
Mailing Address - Fax:
Practice Address - Street 1:5701 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3282
Practice Address - Country:US
Practice Address - Phone:956-791-0080
Practice Address - Fax:956-791-4108
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5406TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist