Provider Demographics
NPI:1386644334
Name:HINER, HERVY HARRISON (MD)
Entity Type:Individual
Prefix:
First Name:HERVY
Middle Name:HARRISON
Last Name:HINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 9TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-3600
Mailing Address - Country:US
Mailing Address - Phone:409-985-6657
Mailing Address - Fax:409-982-7805
Practice Address - Street 1:1750 9TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-3600
Practice Address - Country:US
Practice Address - Phone:409-985-6657
Practice Address - Fax:409-982-7805
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5569207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127696604Medicaid
TX127696604Medicaid
80X410Medicare ID - Type Unspecified