Provider Demographics
NPI:1437611142
Name:HINES, JOHN R II (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:HINES
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 S BUCKNER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-2372
Mailing Address - Country:US
Mailing Address - Phone:214-381-7700
Mailing Address - Fax:
Practice Address - Street 1:4801 S BUCKNER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-2372
Practice Address - Country:US
Practice Address - Phone:214-381-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor